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Updated: Apr 18, 2026
Noninvasive Electrocardiography in the Perinatal Mouse
Published on: June 12, 2020
Electrocardiographic intervals in foetuses with CHD
Betul Yilmaz1, Hari K Narayan1, Abigail Wilpers2
11Department of Pediatrics,Division of Pediatric Cardiology,Morgan Stanley Children's Hospital,Columbia University Medical Center,New York,United States of America.
Insights
Fetal electrocardiographic intervals, including PR and QRS, lengthen with gestational age in healthy fetuses. Congenital heart disease fetuses show significantly longer QRS intervals from 20 weeks gestation.
Area of Science:
- Cardiology
- Prenatal Diagnosis
- Fetal Medicine
Background:
- Congenital heart disease (CHD) is a significant concern in prenatal diagnostics.
- Understanding fetal electrocardiographic (FECG) intervals can aid in early detection.
- Gestational age-specific norms for FECG intervals are crucial for interpretation.
Purpose of the Study:
- To evaluate fetal electrocardiographic intervals (PR, QRS, QT) across gestational ages in fetuses with and without CHD.
- To identify differences in these intervals between fetuses with and without CHD.
- To establish if FECG intervals can differentiate between normal and CHD fetuses early in gestation.
Main Methods:
- A prospective observational cohort study included 92 participants (41 controls, 51 with CHD).
- FECG was serially obtained using maternal abdominal monitoring at 20-24, 28-32, and 34-38 weeks gestation.
- Signal-averaged waveforms were analyzed to measure PR, QRS, and QT intervals, with statistical comparisons between groups.
Main Results:
- PR and QRS intervals correlated with gestational age in control fetuses (p<0.05).
- QRS intervals were significantly longer in fetuses with CHD compared to controls at all measured gestational ages (p<0.001 at 20-24 weeks).
- Differences in QRS intervals were detectable as early as 20 weeks gestation.
Conclusions:
- Fetal PR and QRS intervals normally lengthen with advancing gestational age.
- Fetuses with CHD exhibit prolonged QRS intervals compared to controls.
- FECG analysis can identify fetuses with CHD as early as 20 weeks gestation, aiding in prenatal diagnosis.
Objectives:
To assess foetal electrocardiographic intervals across gestational age among foetuses with and without congenital heart disease, and to investigate differences between groups.
Design:
A prospective observational cohort study.
Setting:
Center for Prenatal Pediatrics, Morgan Stanley Children's Hospital of New York-Presbyterian. Population or sample A total of 92 participants with singleton pregnancies, 41 with normal anatomy and 51 with congenital heart disease were included in this study.
Methods:
Using a maternal abdominal monitor, foetal electrocardiogram was obtained serially from foetuses with and without congenital heart disease at 20-24 weeks (F1), 28-32 weeks (F2), and 34-38 weeks (F3) of gestation. A signal-averaged waveform was calculated, and PR, QRS, and QT intervals were measured. Intervals from controls were compared with gestational age norms. Using Pearson's correlation coefficient, we analysed the relationship between gestational age and foetal electrocardiographic intervals. Intervals from control and congenital heart disease foetuses were compared by Student's t-test.
Results:
PR (r=0.333, p=0.02) and QRS (r=0.248, p=0.05) intervals correlated with gestational age only among controls. QRS intervals in foetuses with congenital heart disease were significantly longer than controls at F1 (63 ± 6 versus 52 ± 5 ms, p<0.001), F2 (61 ± 8 versus 56 ± 7 ms, p=0.02), and F3 (64 ± 10 versus 56 ± 9 ms, p=0.007).
Conclusions:
PR and QRS intervals lengthen across gestational age among foetuses with normal cardiac anatomy but not in foetuses with congenital heart diseases. As early as 20 weeks of gestation, differences between foetuses with and without congenital heart disease are discernible, with congenital heart disease foetuses demonstrating longer QRS intervals compared with controls.
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