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C L Rogé

Publications and source records attributed to C L Rogé.

3 recordsLinked to original sources

Fetal echocardiography: retrospective review of clinical experience and an evaluation of indications.

OBJECTIVE: To assess the indications, use, and yield of fetal echocardiography. METHODS: We reviewed our 8-year experience with fetal echocardiography at a large health maintenance organization in northern California to assess the yield of abnormal findings for each indication and the accuracy of prenatal cardiac diagnosis. The study included 915 fetuses undergoing fetal echocardiography between 18-38 weeks' gestation because of accepted indications. All live-born infants had the presence or absence of congenital heart disease (CHD) confirmed postnatally. RESULTS: Family history of CHD led to 34% of all fetal echocardiography studies, with a detection rate of 0.7%. Maternal diabetes mellitus accounted for 28% of all studies, with a detection rate of 1.2%. Exposure of mothers to a potential teratogen led to 48 studies, but no abnormalities were detected. Only 4% of fetal echocardiograms were obtained because of a suspected heart defect noted on a screening obstetric sonogram; this indication had a detection rate of 68% and yielded by far the most cases of severe CHD. Based on the expected occurrence rate of severe CHD in our closed referral system, only about 15% were referred for fetal echocardiography and detected prenatally. CONCLUSION: Basing fetal echocardiography referral on risk factors misses most clinically significant detectable CHD.

Female↗

Asymmetric septal hypertrophy in infants of diabetic mothers. Fetal echocardiography and the impact of maternal diabetic control.

Maternal hyperglycemia may result in fetal hyperinsulinemia and asymmetric septal hypertrophy, macrosomia, and hypoglycemia in infants of diabetic mothers. We monitored glycosylated hemoglobin levels in 61 pregnant diabetic women each trimester as an index of maternal glycemic control and did serial fetal echocardiograms starting at 18 weeks of gestation. At delivery, cord blood C-peptide levels were obtained as an index of fetal hyperinsulinemia. Infants were assessed for hypoglycemia, macrosomia and septal thickening by echocardiography. Nineteen of the 61 infants (31%) had septal hypertrophy, were heavier, and had higher cord blood C-peptide levels and lower serum glucose levels than unaffected infants. Maternal glycosylated hemoglobin levels were higher during the third trimester in mothers of affected infants. Our data support a possible relationship between third-trimester maternal hyperglycemia and neonatal asymmetric septal hypertrophy, macrosomia, and hypoglycemia.

Echocardiography↗

Cardiac structure growth pattern determined by echocardiography.

Using M-mode echocardiography, we measured dimensions of the ventricular walls and cavities, great vessels, and left atrium and atrioventricular valve excursions on 93 infants and children without heart disease. The data were analyzed by relating each dimension in mm to body surface area in m2 and the 90% tolerance limits for the data were calculated. The tolerance lines of the data were wider than previously recorded. At birth and maturity they were similar to the range defined as normal by studies in neonates and adults. We suggest that the tolerance lines of these normal data may be used for quantitative echocardiography in childhood.

Adolescent↗