Purpose: Fetal echocardiography is the primary diagnostic tool for assessing the atrioventricular (AV) time interval. Establishing a reference range for this parameter throughout pregnancy is essential for the early detection of potential abnormalities. The aim of this study was to develop a Z-score equation and establish specific percentiles for the AV time interval in normal fetuses between 16 and 33+6 weeks of gestation. Methods: A multicenter, prospective, cross-sectional study was conducted between 2018 and 2022. A large sample of pregnant women meeting specific eligibility criteria was included, while cases with potential confounders were excluded. Two-dimensional echocardiography with pulsed Doppler techniques was employed, focusing on the left ventricular inflow and outflow. Data were rigorously analyzed with careful assessment of measurements and normalization procedures. Results: In total, 1,309 echocardiograms were performed, and 1,183 pregnant women were included after applying the eligibility criteria. Detailed percentiles for each gestational age were determined, and a Z-score equation was formulated. A very weak correlation was observed between AV interval measurement and gestational age (r=0.16, P<0.001). In addition, the correlation between AV interval measurement and fetal heart rate was weak (r=-0.21, P<0.001). The Z-score for the AV interval measurement in milliseconds was derived as follows: Z-score=(AV interval measurement-111.3)/8.6. Conclusion This study provides a reference range and Z-score equation for the AV interval, which may enhance the accuracy of monitoring fetuses at risk for developing atrioventricular block—especially in pregnant women with specific antibodies—thus facilitating earlier diagnosis and treatment.

Purpose: Fetal echocardiography is the primary diagnostic tool for assessing the atrioventricular (AV) time interval. Establishing a reference range for this parameter throughout pregnancy is essential for the early detection of potential abnormalities. The aim of this study was to develop a Z-score equation and establish specific percentiles for the AV time interval in normal fetuses between 16 and 33+6 weeks of gestation. Methods: A multicenter, prospective, cross-sectional study was conducted between 2018 and 2022. A large sample of pregnant women meeting specific eligibility criteria was included, while cases with potential confounders were excluded. Two-dimensional echocardiography with pulsed Doppler techniques was employed, focusing on the left ventricular inflow and outflow. Data were rigorously analyzed with careful assessment of measurements and normalization procedures. Results: In total, 1,309 echocardiograms were performed, and 1,183 pregnant women were included after applying the eligibility criteria. Detailed percentiles for each gestational age were determined, and a Z-score equation was formulated. A very weak correlation was observed between AV interval measurement and gestational age (r=0.16, P<0.001). In addition, the correlation between AV interval measurement and fetal heart rate was weak (r=-0.21, P<0.001). The Z-score for the AV interval measurement in milliseconds was derived as follows: Z-score=(AV interval measurement-111.3)/8.6. Conclusion This study provides a reference range and Z-score equation for the AV interval, which may enhance the accuracy of monitoring fetuses at risk for developing atrioventricular block—especially in pregnant women with specific antibodies—thus facilitating earlier diagnosis and treatment.

Purpose: Fetal echocardiography is the primary diagnostic tool for assessing the atrioventricular (AV) time interval. Establishing a reference range for this parameter throughout pregnancy is essential for the early detection of potential abnormalities. The aim of this study was to develop a Z-score equation and establish specific percentiles for the AV time interval in normal fetuses between 16 and 33+6 weeks of gestation. Methods: A multicenter, prospective, cross-sectional study was conducted between 2018 and 2022. A large sample of pregnant women meeting specific eligibility criteria was included, while cases with potential confounders were excluded. Two-dimensional echocardiography with pulsed Doppler techniques was employed, focusing on the left ventricular inflow and outflow. Data were rigorously analyzed with careful assessment of measurements and normalization procedures. Results: In total, 1,309 echocardiograms were performed, and 1,183 pregnant women were included after applying the eligibility criteria. Detailed percentiles for each gestational age were determined, and a Z-score equation was formulated. A very weak correlation was observed between AV interval measurement and gestational age (r=0.16, P<0.001). In addition, the correlation between AV interval measurement and fetal heart rate was weak (r=-0.21, P<0.001). The Z-score for the AV interval measurement in milliseconds was derived as follows: Z-score=(AV interval measurement-111.3)/8.6. Conclusion This study provides a reference range and Z-score equation for the AV interval, which may enhance the accuracy of monitoring fetuses at risk for developing atrioventricular block—especially in pregnant women with specific antibodies—thus facilitating earlier diagnosis and treatment.

Purpose: Fetal echocardiography is the primary diagnostic tool for assessing the atrioventricular (AV) time interval. Establishing a reference range for this parameter throughout pregnancy is essential for the early detection of potential abnormalities. The aim of this study was to develop a Z-score equation and establish specific percentiles for the AV time interval in normal fetuses between 16 and 33+6 weeks of gestation. Methods: A multicenter, prospective, cross-sectional study was conducted between 2018 and 2022. A large sample of pregnant women meeting specific eligibility criteria was included, while cases with potential confounders were excluded. Two-dimensional echocardiography with pulsed Doppler techniques was employed, focusing on the left ventricular inflow and outflow. Data were rigorously analyzed with careful assessment of measurements and normalization procedures. Results: In total, 1,309 echocardiograms were performed, and 1,183 pregnant women were included after applying the eligibility criteria. Detailed percentiles for each gestational age were determined, and a Z-score equation was formulated. A very weak correlation was observed between AV interval measurement and gestational age (r=0.16, P<0.001). In addition, the correlation between AV interval measurement and fetal heart rate was weak (r=-0.21, P<0.001). The Z-score for the AV interval measurement in milliseconds was derived as follows: Z-score=(AV interval measurement-111.3)/8.6. Conclusion This study provides a reference range and Z-score equation for the AV interval, which may enhance the accuracy of monitoring fetuses at risk for developing atrioventricular block—especially in pregnant women with specific antibodies—thus facilitating earlier diagnosis and treatment.

Purpose: Fetal echocardiography is the primary diagnostic tool for assessing the atrioventricular (AV) time interval. Establishing a reference range for this parameter throughout pregnancy is essential for the early detection of potential abnormalities. The aim of this study was to develop a Z-score equation and establish specific percentiles for the AV time interval in normal fetuses between 16 and 33+6 weeks of gestation. Methods: A multicenter, prospective, cross-sectional study was conducted between 2018 and 2022. A large sample of pregnant women meeting specific eligibility criteria was included, while cases with potential confounders were excluded. Two-dimensional echocardiography with pulsed Doppler techniques was employed, focusing on the left ventricular inflow and outflow. Data were rigorously analyzed with careful assessment of measurements and normalization procedures. Results: In total, 1,309 echocardiograms were performed, and 1,183 pregnant women were included after applying the eligibility criteria. Detailed percentiles for each gestational age were determined, and a Z-score equation was formulated. A very weak correlation was observed between AV interval measurement and gestational age (r=0.16, P<0.001). In addition, the correlation between AV interval measurement and fetal heart rate was weak (r=-0.21, P<0.001). The Z-score for the AV interval measurement in milliseconds was derived as follows: Z-score=(AV interval measurement-111.3)/8.6. Conclusion This study provides a reference range and Z-score equation for the AV interval, which may enhance the accuracy of monitoring fetuses at risk for developing atrioventricular block—especially in pregnant women with specific antibodies—thus facilitating earlier diagnosis and treatment.

This pictorial review describes the assessment of a great variety of types of congenital heart disease by three-dimensional ultrasonography with spatiotemporal image correlation using HDlive and the HDlive Flow silhouette rendering mode. These technologies provide fetal heart surface patterns by using a fixed virtual light source that propagates into the tissues, permitting a detailed reconstruction of the heart structures. In this scenario, ultrasound operators can freely select a better light source position to enhance the anatomical details of the fetal heart. HDlive and the HDlive Flow silhouette rendering mode improve depth perception and the resolution of anatomic cardiac details and blood vessel walls compared to standard two-dimensional ultrasonography.

Objective: To assess the mitral and tricuspid annular plane systolic excursions (MAPSE and TAPSE, respectively) and cardiac output (CO) in fetuses of pregnant women with pregestational diabetes mellitus (DM) using spatio-temporal image correlation M-mode (STIC-M) and virtual organ computer-aided analysis (VOCAL). Methods: This study was prospective and cross-sectional. It included 45 fetuses each from mothers with pregestational DM and healthy mothers, with gestation ages ranging from 20 to 36.6 weeks. The fetal cardiac volumes were obtained and analyzed by STIC and VOCAL methods. MAPSE and TAPSE were measured by STIC-M in the apical or basal fourchamber view. The values of the right (RV) and left ventricular (LV) CO were calculated by STIC and VOCAL. Results: The median values of TAPSE were 6.1 and 6.2 mm in the diabetic and control groups (P<0.001), respectively. The median values of MAPSE were 4.6 mm in the fetuses of mothers with diabetes and 4.8 mm in fetuses of healthy mothers. The fetal LV CO (60.4 L/min vs. 71.1 L/min; P=0.033, respectively) and RV CO (65.2 vs. 70.1 L/min; P=0.026, respectively) were lower in the pregestational DM group than in the control group. A significant effect of pregestational DM was observed in all functional parameters after adjusting, with fetal heart rate as covariant. There was moderate significant positive correlation between MAPSE and LV CO (r=0.53; P=0.0001) and between TAPSE and RV CO (r=0.46; P=0.0001). Conclusion Significant difference in functional parameters (TAPSE, MAPSE and LV CO) obtained by STIC and VOCAL were observed in the fetuses of the pregestational DM group compared to those of the control group.

Objective: To assess the mitral and tricuspid annular plane systolic excursions (MAPSE and TAPSE, respectively) and cardiac output (CO) in fetuses of pregnant women with pregestational diabetes mellitus (DM) using spatio-temporal image correlation M-mode (STIC-M) and virtual organ computer-aided analysis (VOCAL). Methods: This study was prospective and cross-sectional. It included 45 fetuses each from mothers with pregestational DM and healthy mothers, with gestation ages ranging from 20 to 36.6 weeks. The fetal cardiac volumes were obtained and analyzed by STIC and VOCAL methods. MAPSE and TAPSE were measured by STIC-M in the apical or basal fourchamber view. The values of the right (RV) and left ventricular (LV) CO were calculated by STIC and VOCAL. Results: The median values of TAPSE were 6.1 and 6.2 mm in the diabetic and control groups (P<0.001), respectively. The median values of MAPSE were 4.6 mm in the fetuses of mothers with diabetes and 4.8 mm in fetuses of healthy mothers. The fetal LV CO (60.4 L/min vs. 71.1 L/min; P=0.033, respectively) and RV CO (65.2 vs. 70.1 L/min; P=0.026, respectively) were lower in the pregestational DM group than in the control group. A significant effect of pregestational DM was observed in all functional parameters after adjusting, with fetal heart rate as covariant. There was moderate significant positive correlation between MAPSE and LV CO (r=0.53; P=0.0001) and between TAPSE and RV CO (r=0.46; P=0.0001). Conclusion Significant difference in functional parameters (TAPSE, MAPSE and LV CO) obtained by STIC and VOCAL were observed in the fetuses of the pregestational DM group compared to those of the control group.

Objective: To analyze the association between oocyte quality and decreased ovarian reserve (DOR) markers in young women undergoing controlled ovarian stimulation (COS). Methods: This retrospective study included 49 patients classified as having DOR based on anti-Müllerian hormone (AMH) levels, follicle-stimulating hormone (FSH) levels, or antral follicle counts (AFCs; <10). Images of all obtained oocytes were analyzed, and oocyte quality was classified according to maturity and morphology. The COS protocol utilized gonadotropin (FSH and/or human menopausal gonadotropin [hMG]) doses ranging from 150 to 300 IU/day. The Student’s t test or Mann-Whitney test was used to compare the groups. Spearman’s coefficients were estimated to verify the correlation between the administered dose of FSH/hMG and the number of mature oocytes. To evaluate the association between patient- and oocyte-related variables, logistic regression models were adjusted. Results: Women with DOR classified according to FSH level had more immature oocytes (P<0.001). Women with DOR according to AMH had fewer mature oocytes and increased basal FSH levels (P<0.001). Women with DOR according to AFC had an increased risk of abnormally shaped oocytes (P=0.035). Conclusion This study showed that DOR based on AMH levels, FSH levels, and AFC was associated with poorer quality oocytes in young women who underwent COS.

Objective: To evaluate the serum levels of adiponectin and leptin and their relationship with nutritional variables during pregnancy in adolescents. Methods: This prospective cohort study evaluated eutrophic pregnant adolescents (body mass index [BMI], 18.5–24.9 kg/m2) during the 3 gestational trimesters (first, 10–14 weeks; second, 24–28 weeks; and third, 30–34 weeks). Serum adiponectin and leptin concentrations were measured using the enzyme-linked immunosorbent assay method. The relationship of these adipokines with the pre-gestational BMI, gestational weight gain, weight at the time of sample collection, and newborn weight were evaluated. Analysis of variance and the Kruskal-Wallis test were used for statistical analysis. Results: The study group comprised 62 pregnant adolescents. The serum concentration of adiponectin showed a significant difference between the first and third trimesters (P=0.003), which decreased during pregnancy, but unrelated to nutritional variables. Serum leptin levels increased throughout the pregnancy (P<0.0001) and showed a positive correlation with pre-gestational BMI, total weight gain, pregnancy weight at the time of sample collection, and newborns’ weight. Conclusion Serum levels of adiponectin and leptin vary inversely throughout pregnancy. This pattern in adolescents is similar to that observed in adults. Moreover, leptin concentrations increased throughout pregnancy, and they were positively correlated with all variables evaluated.