Prenatal study of fetal endocardial hyperrefringence and its relation to maternal toxoplasmosis.
OBJECTIVE
To compare a group of fetuses whose mothers had acute or recent toxoplasmosis with a group of fetuses whose mothers had no systemic disease, analyzing the presence of changes in endocardial refringence.


METHODS
This study assessed 91 fetuses of mothers diagnosed with acute or recent toxoplasmosis, detected by seroconversion or the presence of elevated IgM and IgG titers, confirmed through the IgM-capture ELISA. They were compared with a control group comprising 182 fetuses selected from a low-risk population participating in a prenatal screening program for heart diseases.


RESULTS
No significant difference was observed between the mean gestational (29.2+/-4.6 weeks; 29.2+/-4.6 weeks) and maternal (25.7+/-6.7 years; 26+/-5.4 years) ages in the 2 groups. Areas of endocardial hyperechogenicity were observed in 69 fetuses whose mothers had toxoplasmosis (75.8%) and in only 6 fetuses of the control group (3.3%) (P<0.001). In 52 patients of the group studied (75.4%), endocardial hyperrefringence was diffuse, and, in 17 (24.3%), it was focal. In the control group, focal distribution was observed in 5 fetuses (83.3%).


CONCLUSIONS
The prenatal echocardiographic image of focal or diffuse endocardial hyperrefringence is more prevalent in pregnancies with maternal toxoplasmosis than in the healthy ones, and an association between fetal endocardial hyperechogenicity and maternal disease exists.
Instituto de Cardiologia do Rio Grande do Sul, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brasil.
Luiz Henrique Soares
LH
Nicoloso
Tiene Zingano
TZ
Henke
Paulo
P
Zielinsky
D000208:Acute Disease; D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D005318:Fetal Heart / Q000648:ultrastructure*; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D011247:Pregnancy; D014125:Toxoplasmosis, Congenital / Q000000981:diagnostic imaging*; D016216:Ultrasonography, Prenatal