FUNCTIONAL PULMONARY VALVE REGURGITATION IN THE FETUS

Objective The purpose of this study was to determine the prevalence an d the characteristics of functional pulmonary valve regurgitation in n ormally grown fetuses. Design A prospective cross-sectional study. Sub jects A total of 1115 singleton fetuses between 18 and 41 weeks of ges tation and who had normal heart anatomy normal estimated weighs for ge stational age and normal flow velocity waveforms in the umbilical and middle cerebral arteries and umbilical vein were examined. Cases with agenesis, constriction or other abnormalities of the ductus arteriosus were excluded. Methods Examination of the pulmonary valve was perform ed by color Doppler echocardiography, pulsed wave Doppler and, if nece ssary, continuous wave Doppler in the short-axis view at the level of the origin of the great arteries and/or in a subcostal view of the rig ht ventricular outflow tract and pulmonary trunk. If pulmonary valve r egurgitation was detected by color Doppler flow imaging and confirmed by pulsed wave Doppler echocardiography, the maximum velocity of the r egurgitant jets as well as their maximum lengths were measured. Result s The prevalence of functional pulmonary valve regurgitation was 0.54% (n = 6). Pulmonary valve regurgitation was part diastolic in four cas es and holodiastolic in two cases, with maximum velocity of less than or equal to 2.05 mis and maximum length of 3-8 mm. Prenatal re-examina tion of five of the six fetuses with pulmonary valve regurgitation sho wed that pulmonary valve regurgitation was a transient phenomenon in f our cases. The fetal outcome in the presence of transient pulmonary va lve regurgitation was normal; pediatric echocardiographic examination in these six fetuses with transient pulmonary valve regurgitation show ed no regurgitations or other cardiac anomalies. Conclusions Pulmonary valve regurgitation was Junctional in all six fetuses.