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While it is possible to perform balloon valvuloplasty of a critically stenosed pulmonary valve in the fetus safely, the majority of serious heart conditions remain undiagnosed until after birth. This article addresses the successes and shortcomings of fetal cardiology.
Interval index (II) is a product of statistical analysis of fetal heart intervals measured from fetal electrocardiography and it describes the long term variability. II and three visual parameters of fetal heart rate (FHR) accelerations: the number of accelerations, the heights of maximal acceleration and the sum of accelerations in 40 five-minute samples of abdominal fetal electrography were compared to find out whether II could be used as an automated objective measure of FHR accelerations (r = 0.85), but the correlation was highly significant also with the maximal acceleration and the number of ac-FHR had a poor correlation with accelerations.
In nonimmunologic hydrops fetalis associated with heart anomaly, plasma human atrial natriuretic peptide (hANP) values in umbilical venous blood were significantly higher than those in normal infants. These findings indicate that significant release of hANP from atria is induced by the decompensatory state of the fetal heart.
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Ultrasonic diagnosis is widely used today in obstetrics and gynecology. As no harmful side-effects, neither to the mother nor to the fetus can be detected, the method can be used to study the fetal development in its natural environment. The technics used for this study are either compound-scan or real-time scan. Progressing from the early to the late pregnancy the clinical problems, in which ultrasonic diagnosis is of importance are discussed. In early pregnancies these problems are related with the symptoms of abortion, whereby intact pregnancy, blighted ovum, missed abortion, ectopic pregnancy and hydatidiform mole, can be differentiated by ultrasonic examination. In advanced pregnancies ultrasonic examinations are used to achieve biometric data reflecting normal and abnormal progress in the uterine fetal development. Such data are the biparietal diameter and abdominal measurements such as diameter and circumferences which may be influenced by placental insufficiency resulting in growth retardation. The importance of the exact location of the placenta using echography as well as the possibility of the exact diagnosis of the fetal position are stressed. In gynecology echography can be used for monitoring the ovarian cycle in demonstrating the maturing follicle and the corpus luteum. Tumors of the genital organ can be differentiated to a certain extent. In the management of patients suffering from cancer, ultrasonography can be used for treatment-planning and in the follow-up study to detect local or lymphonodal recurrences as early as possible and to plan second-look operations.
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