Echocardiographic evaluation of dilated cardiomyopathy in the human fetus.
The diagnosis of dilated cardiomyopathy was established and subsequently confirmed in 6 of 625 fetuses studied by echocardiography. All 6 had structurally normal hearts. Abnormal findings included reduced fractional shortening index in 5, atrioventricular valve regurgitation in 3, abnormal chamber dimensions in 3 and nonimmune hydrops in 4. In 2 fetuses referred because of a family history of dilated cardiomyopathy in previous siblings, echocardiographic abnormalities were absent on a first examination performed at 20 weeks of gestation. This suggested that a normal fetal echocardiogram in a midtrimester fetus does not always rule out the subsequent development of dilated cardiomyopathy. However, all fetuses followed serially developed some abnormality later in pregnancy. Only 2 neonates survived, 1 of whom required a heart transplant during infancy. Death from cardiac failure occurred in 1 fetus and 3 neonates. This study demonstrates that dilated cardiomyopathy may develop during fetal life and might be diagnosed by echocardiography if serial studies are performed. Dilated cardiomyopathy presenting prenatally appears to have a poor prognosis.
Schmidt
K G
KG
Division of Pediatric Cardiology, University of California, San Francisco 94143.
Birk
E
E
Silverman
N H
NH
Scagnelli
S A
SA
D002311:Cardiomyopathy, Dilated / Q000175:diagnosis*; D004452:Echocardiography; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D005318:Fetal Heart / Q000033:anatomy & histology; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis; D014463:Ultrasonography