Longitudinal observations in normally grown fetuses with tricuspid valve regurgitation: report of 22 cases.

Abstract

Longitudinal observations of tricuspid valve regurgitation were prospectively performed in 22 singleton fetuses with normal anatomy, normal biometry and normal Doppler to determine the characteristics of functional tricuspid valve regurgitation. Tricuspid valve regurgitation was semi-quantified by spatial and temporal Doppler-derived parameters. In 18 cases tricuspid valve regurgitation was part-systolic (early and mid-systolic) and showed little spatial expansion of the jet as examined by colour Doppler flow imaging. In 16 of these 18 cases the maximum velocity of these regurgitant jets was below 2.00 m/s. Four fetuses demonstrated holosystolic regurgitant jets and in addition to the longer duration of these jets, the spatial expansion was also greater and the maximum velocity was slightly higher compared with the part-systolic tricuspid valve regurgitations. Re-examination of the 22 normally grown fetuses showed that tricuspid valve regurgitation was a transient phenomenon. Within a period of one to seven weeks after the diagnosis of tricuspid valve regurgitation, the regurgitation could no longer be demonstrated in any of these cases, including the four fetuses with holosystolic regurgitant jets. Tricuspid valve regurgitation was the only detected abnormality in all of these cases. The fetal outcome of the 22 normally grown fetuses with tricuspid valve regurgitation was unremarkable concerning the evaluated parameters. Although fetal tricuspid valve regurgitation may be a sign of increased preload, afterload or cardiac dysfunction, in most cases tricuspid valve regurgitation is an isolated transient phenomenon with little temporal and spatial expansion; nevertheless in some cases holosystolic tricuspid valve regurgitation may also be an isolated transient finding, and it may be a functional phenomenon.