Echocardiographic diagnosis of fetal marfan syndrome at 34 weeks' gestation

Fetal echocardiography was performed during the third trimester in a normal primigravida. The fetal heart was severely affected with the typical cardiac manifestations of Marfan syndrome. The medical history of the father was investigated and a mild form of the syndrome was diagnosed. The neonate died at 2 months of age of congestive heart failure.     

Changes in the central and peripheral circulatory system in response to the cold: own studies using impedance plethysmography and Doppler ultrasound

The aim of the study was to determine the cardiovascular response to continuous (4 °C for 60 min) and intermittent (10 min at 4?°C and 10 min at room temperature alternately) exposure to the cold in 30 healthy young men. The subjects were equipped with a set of identical clothing (insulation 2.1 clo) and during the stay in the chamber and outside performed the same activities, i.e., walking on a treadmill at a speed of 0.5?km/h. The tests included assessing the central circulatory system using the Holter system and assessing the peripheral circulatory system using impedance plethysmography and Doppler ultrasound. The analysis of the parameters that describe the central and peripheral circulation poses a difficulty in determining which variant of exposure constitutes a greater load on the circulatory system. It should be noted that even the conditions used in the study may cause adverse effects in the cardiovascular system.     

Methods for prenatal assessment of fetal cardiac function

Fetal cardiac function is increasingly recognized as a marker of disease severity and prognosis in selected fetal conditions. Magnetic resonance imaging (MRI) has been used in experimental (animal) fetal cardiology but the lack of a noninvasive fetal electrocardiogram (ECG) to trigger image acquisition remains a major limiting factor precluding its application in humans. Fetal medicine specialists are therefore limited to ultrasound to evaluate human fetal cardiac function. In this review, we aim to provide a complete overview of the different ultrasound techniques that can be used for fetal cardiac function assessment and we discuss their (theoretical) strengths and shortcomings. Conventional methods include M-mode assessment of ventricular contractility and Doppler assessment of the precordial veins and cardiac output (CO). More recent techniques such as the measurement of the myocardial performance index (MPI), myocardial motion analysis with tissue Doppler, speckle tracking and three-dimensional (3D) ultrasound techniques are also discussed. Copyright © 2009 John Wiley & Sons, Ltd.