Excursion index of the septum primum in Thai fetuses of gestational diabetic mothers at 32 to 35 weeks' gestation.

OBJECTIVE: To compare excursion index of the septum primum (EISP) among Thai fetuses of gestational diabetic mothers (FGDMs) with and without septal hypertrophy (SH) and those of nondiabetic mothers from 32 to 35 weeks' gestation. MATERIAL AND METHOD: Fetuses of Thai pregnant women were recruited for prenatal 2-dimensional echocardiographic measurements of the EISP (the ratio between the linear displacement of the flap valve of septum primum and the left atrial diameter) at 32 to 35 weeks' gestation. All had confirmed gestational age and normal structural scanning. The EISP was compared among gestational age--matched 15 FGDMs with SH, 18 FGDMs with normal septal thickness, and 20 fetuses of nondiabetic mothers. The data were presented as mean and standard deviation (SD). Analysis of variance (ANOVA) was used to compare the EISP of the three groups. RESULTS: Fifty-three measurements were obtained. Comparison among the three groups showed that the mean and SD of the EISP were 0.27 +/- 0.04, 0.50 +/- 0.04 and 0.51 +/- 0.05 in FGDMs with SH, normal septal thickness and those of nondiabetic mothers, respectively. The analysis demonstrated that the EISP was significantly less than in FGDMs with SH when compared to the FGDMs with normal septal thickness and those of nondiabetic mothers (p < 0.01). There was no significant difference in the EISP of the FGDMs with normal septal thickness and those of nondiabetic mothers (p = 0.16). CONCLUSION: Mobility of the septum primum in FGDMs with septal hypertrophy is reduced. This may indicate a higher preload compared to FGDMs with normal septal thickness and those of nondiabetic mothers.

Excursion index of the septum primum as a parameter for diastolic function assessment of Thai fetuses: at 32 to 35 weeks' gestation.

OBJECTIVE: To establish the normal value of fetal diastolic function by the measurement of the excursion index of the septum primum (EISP) from 32 to 35 weeks' gestation in Thai fetuses. MATERIAL AND METHOD: Fetuses of normal Thai pregnant women were recruited for 2-dimensional echocardiographic measurements of the EISP (the ratio between the linear displacement of the flap valve and the left atrial diameter) from 32 to 35 weeks' gestation. All had a confirmed gestational age, normal structural scanning, and negative diabetic screening at 24 to 28 weeks' gestation. The 5th, 50th and 95th percentile of the EISP were demonstrated The relationship between the EISP and gestational age were determined RESULTS: Three hundred twenty-seven measurements were obtained The normal values of the EISP according to gestational age were presented as 5th, 50th, and 95th percentile ranks. The correlation coefficients (r) between the EISP and gestational age were 0.03. The EISP were not statistically different with advancing gestation. The 5th, 50th, and 95th of the EISP were 0.32, 0.45, and 0.59 respectively. The intra-observer variability was 5.5%. CONCLUSION: The normal values of fetal EISP in the Thai population from 32 to 35 weeks' gestation were established This could serve as a baseline data in detection of the alteration of left ventricular diastolic function during fetal life.

Interventricular septal thickness of Thai fetuses: at 32 to 35 weeks' gestation.

OBJECTIVE: To establish the normal value of fetal InterVentricular Septal Thickness (IVST) from 32 to 35 weeks' gestation in Thai fetuses. MATERIAL AND METHOD: Thai pregnant women with normal fetuses were recruited for prenatal 2-dimensional M-mode echocardiographic measurements of fetal IVST at 32 to 35 weeks' gestation. All had a confirmed gestational age, normal structural scanning and negative diabetic screening at 24 to 28 weeks 'gestation. The IVST was measured from the 4-chamber view during diastole and systole. The 5th, 50th and 95th percentile of the IVST during Diastole (IVSD) and the IVST during Systole (IVSS) were demonstrated The relationship between the IVSD and IVSS and gestational age were determined RESULTS: A total of 410 measurements were obtained. The normal values of the IVSD and IVSS according to gestational age were presented as 5th, 50th and 95th percentile ranks. The correlation coefficients (r) between the IVSD and IVSS and gestational age were 0.11 and 0.12, respectively. The IVSD and IVSS were not statistically different with advancing gestation. The 95th, percentile of the IVSD was 4.51 millimeters (mm) (range = 4.26 to 4.74 mm) and IVSS was 6.23 mm (range = 5.96 to 6.68 mm). The intraobserver variability was 7.6%. CONCLUSION: The normal values of fetal IVSD and IVSS in a Thai population from 32 to 35 weeks' gestation were established. This could be used as a baseline data in detecting the asymmetrical septal hypertrophy during fetal life.