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Fetal Endocardial Hiperechogenicity:
A Possible Prenatal Echocardiographic
Marker of Maternal Toxoplasmosis

Zielinsky, P.; Mastalir, E.T.; Nicoloso, L.H.;
Gutierrez, L.E.; Piazza, L.; Buffé, F.; Gianisella, R.

Fetal Cardiology Unit, Institute of Cardiology of
Rio Grande do Sul. Porto Alegre, Brasil

Introduction: Toxoplasmosis is a systemic infectious disease caused by Toxoplasma gondii. Acute infection during pregancy determines well established fetal sequelae which occur mainly in central nervous system, heart and eyes. Routine prenatal echocardiographic observation of patients with acute toxoplasmosis raised the suspicion that fetal endocardial hyperechogenic foci could be a prevalent finding.

Objective: To confirm the hypothesis that focal or diffuse endocardial hiperechogenicty occurs more frequently in fetuses of mothers with acute toxoplasmosis than in normal fetuses without risk factors for congenital heart disease.
Design of the study: case-control study with prevalent cases.

Methods: Sixty consecutive fetuses cases from mothers with acute gestational toxoplasmosis, detected by high IGM titles were examined by means of fetal echocardiography and compared to 353 normal consecutive fetuses from a low-risk populational screening program (controls), in order to look for endocardial echogenic foci.

Results: Among the cases, 57 (95%) presented focal or diffuse endocardial hiperechogenicity, while only 18 (5%) of the control fetuses showed endocardial foci. Postnatal follow-up (mean=4,6 months) in 13 cases showed complete disappearance of the findings in 83%.

Conclusion: Fetal endocardial hiperechogenicity (focal or diffuse) occurs more frequently in maternal toxoplasmosis than in normal pregnancies.This alteration, might represent an (inespecific) echocardiographic marker of endocardial inflammatory process, with a trend towards recovery in the first months of postnatal life.



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2nd Virtual Congress of Cardiology

Dr. Florencio Garófalo
Steering Committee
Dr. Raúl Bretal
Scientific Committee
Dr. Armando Pacher
Technical Committee - CETIFAC

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