title: Understanding congenital heart defects through abdominal fetal electrocardiography: case reports and clinical implications.
abstract: OBJECTIVE
  Congenital heart defects are the most common fetal structural anomalies of which a significant number remain unrecognized during postnatal life. Fetal electrocardiography (FECG) is an ideal clinical tool to complement ultrasonography for the screening and management of these cases where early and accurate diagnoses would allow definite rather than palliative treatment. The objective of this report was to correlate the particular FECG results found with the different types of congenital heart defects involved and to further demonstrate the usefulness of FECG in clinical settings.
  
  
  METHODS
  This is a report of four cases of prenatally diagnosed congenital heart defects seen at a university hospital in Sendai, Japan. Their complete and thorough evaluation included, among other tests, abdominal FECG analysis.
  
  
  RESULTS
  The presence of premature ventricular contractions, a prolonged pre-ejection period (PEP > 75 msec), and prolonged QTc intervals (QTc > 440 msec) served as markers of hemodynamic alteration but were unlikely determinants of disease severity precluding further investigation.
  
  
  CONCLUSIONS
  In practice, similar findings found on FECG should raise the index of suspicion for the presence of congenital heart disease and prompt a targeted ultrasound scan.
authors.affiliation: Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan. chinkeyvelayo@yahoo.com
authors.forename: Clarissa
authors.initials: C
authors.lastname: Velayo
authors.forename: Naoaki
authors.initials: N
authors.lastname: Sato
authors.forename: Takuya
authors.initials: T
authors.lastname: Ito
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Chisaka
authors.forename: Nobuo
authors.initials: N
authors.lastname: Yaegashi
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Okamura
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Kimura
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011296:Prenatal Diagnosis; D012680:Sensitivity and Specificity