Key result
Increasing gestational age was associated with a significant decrease in the redundancy index of the primary atrial septum across three serial examinations (0.55, 0.48, and 0.41; p < 0.05).
Observational (n=15)
The mobility of the primary atrial septum flap valve decreases as gestational age increases, potentially explaining the reduction in premature atrial beats throughout fetal development.
May refine fetal arrhythmia models; leaves open whether declining septal mobility explains fewer premature atrial beats.
It has already been suggested that redundancy of the primary atrial septum could be associated with primary fetal arrhythmias. There are few reports, however, concerning the mobility of the primary septum and its behavior during fetal life. In this study, fifteen fetuses without anatomic heart disease were serially evaluated by fetal echocardiography. The time interval between three separate examinations was at least two weeks. A redundancy index was calculated as the ratio between the maximum excursion of the flap valve of the septum and the maximal left atrium as seen in a four chamber view. The indexes observed in the three examinations were: 0.55 +/- 0.15, 0.48 +/- 0.13 and 0.41 +/- 0.13, respectively. Analysis of variance for normal distribution and Tukey's test were performed. A significant decrease (p < 0.05) in the redundancy index was observed with increasing gestational age. We postulate that this finding may be related to the decrease in frequency of premature atrial beats throughout fetal life.
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Firpo et al. (1998) conducted an observational in Fetuses without anatomic heart disease (n=15). Increasing gestational age vs. Earlier gestational age was evaluated on Redundancy index (ratio between maximum excursion of the flap valve of the septum and the maximal left atrium) (p=<0.05). Increasing gestational age was associated with a significant decrease in the redundancy index of the primary atrial septum across three serial examinations (0.55, 0.48, and 0.41; p < 0.05).
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