title: Disproportionate septal hypertrophy associated with erythroblastosis fetalis.
abstract: We retrospectively reviewed clinical and echocardiographic data on 10 newborns with erythroblastosis fetalis who were admitted to our nurseries between 1984 and 1988 and who required a double-volume exchange transfusion and neonatal intensive care. Echocardiograms were performed in the first 48 hours of life. In 5 patients, disproportionate septal hypertrophy was demonstrated; 1 additional patient had biventricular hypertrophy with a thickened septum but not disproportionate septal hypertrophy. The mean septal: left ventricular free-wall ratio for the group (n = 10) was 1.37. No correlation was apparent between the occurrence of disproportionate septal hypertrophy and newborn glucose, bilirubin, or hematocrit values. When analyzed separately, the 4 patients who did not receive intrauterine blood transfusions had a ratio of 1.73 +/- 0.21 (mean +/- SEM); this was significantly greater than the ratio in the 6 patients who were transfused in utero (1.13 +/- 0.24). In patients who underwent transfusions, there was no correlation between the number of transfusions and the septal:left ventricular ratio. This study reports a significant but previously unrecognized cardiac hypertrophy with disproportionate septal hypertrophy in patients with erythroblastosis fetalis. Our data suggest a sparing effect of intrauterine fetal transfusions. The mechanism by which these transfusions may affect the hypertrophic development of the myocardium remains to be determined.
authors.affiliation: Lubchenco Center for Perinatal Research, University of Colorado School of Medicine, Denver.
authors.forename: B S
authors.initials: BS
authors.lastname: Carter
authors.forename: J E
authors.initials: JE
authors.lastname: DiGiacomo
authors.forename: S M
authors.initials: SM
authors.lastname: Balderston
authors.forename: J W
authors.initials: JW
authors.lastname: Wiggins
authors.forename: G B
authors.initials: GB
authors.lastname: Merenstein
mesh_terms: D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D004452:Echocardiography; D004899:Erythroblastosis, Fetal / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D006400:Hematocrit; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications / Q000503:physiopathology; D015994:Incidence; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D012189:Retrospective Studies