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Measurement of fetal atrioventricular time intervals: A comparison of 3 spectral Doppler techniques

Sanitra Anuwutnavin1, Kamonwan Kolakarnprasert2, Pharuhas Chanprapaph1

  • 1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Prenatal Diagnosis
|April 11, 2018
PubMed

Insights

Fetal atrioventricular (AV) time intervals measured by pulsed-wave Doppler increase with gestational age and decrease with fetal heart rate. These measurements show excellent reproducibility across three techniques.

Area of Science:

  • Cardiology
  • Fetal Medicine
  • Medical Imaging

Background:

  • Fetal atrioventricular (AV) time intervals are crucial indicators of cardiac function.
  • Standardized methods for assessing these intervals are needed for accurate fetal health monitoring.

Purpose of the Study:

  • To establish nomograms for fetal AV time intervals using three distinct pulsed-wave Doppler techniques.
  • To evaluate the reproducibility of these Doppler methods in assessing fetal AV intervals.

Main Methods:

  • A cross-sectional study involving 311 normal fetuses (16-38 weeks gestation).
  • Pulsed-wave Doppler assessed AV intervals via left ventricular inflow/outflow (LV in/out), superior vena cava/ascending aorta (SVC/AA), and pulmonary artery/pulmonary vein (PA/PV).
  • Linear regression analyzed correlations with gestational age (GA) and fetal heart rate (FHR); reproducibility assessed using intraclass correlation coefficients.

Main Results:

  • Pulmonary artery and pulmonary vein (PA/PV) showed the longest mean AV time intervals.
  • All methods demonstrated positive correlations with GA and negative correlations with FHR.
  • Superior vena cava and ascending aorta (SVC/AA) intervals showed the least influence from FHR.
  • All methods exhibited excellent intraobserver and interobserver reliability (ICC ≥ 0.80).

Conclusions:

  • Fetal AV time intervals, assessed by pulsed-wave Doppler, increase with gestational age and decrease with fetal heart rate.
  • These measurements are clinically viable and reproducible, supporting their use in fetal assessment.
Abstract

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