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Objectives: The primary aim of this study was to evaluate fetal cardiac systolic and diastolic function using the tissue Doppler technique in pregnancies with complications of fetal growth restriction (FGR) and to examine the relationship between FGR with umbilical artery Doppler parameters and fetal cardiac function in complicated pregnancies. Material and methods: This study included 30 pregnant women with FGR complications and 46 pregnant women without FGR complications. Both groups were at 24–34 gestational weeks. Fetal cardiac examination was performed using pulsed Doppler and tissue Doppler imaging (TDI) in all pregnancies. In the analysis of myocardial tissue by tissue Doppler, the tracing obtained from the junction of the tricuspid valve annulus with the right ventricle was recorded by measuring the duration of the isovolumetric contraction wave (IVC), ejection time (ET), and isovolumetric relaxation time (IVR). Furthermore, we calculated the myocardial performance index (MPI) and then measured and recorded the early diastolic annular rate. Results: Based on the TDI studies, the mean IVC and IVR values were significantly longer and the ET values were significantly shorter in the study group than those in the control group. The study group also had significantly longer MPI measurements. Conclusions: Because TDI is a considerably more sensitive method than cardiac sonographic evaluation using pulsed Doppler, tissue Doppler parameters facilitate the detection of cardiac dysfunction at a relatively early stage. In addition, TDI and myocardial evaluation in fetuses with FGR can be noninvasively performed in clinical practice.

Objectives: The aim of the study was to analyze the changes in cardiac function and myocardial contractility of donor and recipient fetuses with twin-to-twin transfusion syndrome (TTTS) subjected to selective laser photocoagulation of the communicating vessels (SLPCV), between and after the procedure. Finally, we verified if fetuses with Quintero’s stage I TTTS presented with early impairment of myocardial contractility. Material and methods: We selected 77 consecutive women with twin pregnancies, whose both fetuses survived at least seven days post-SLPCV. Myocardial contractility of both fetuses was evaluated ultrasonographically, and their myocardial performance indices (Tei-Index values) and shortening fractions (SF) were determined. Results: In donor fetuses, the Tei-Index values for both right and left ventricle remained within the respective reference ranges both before the procedure and during a 7-day follow-up. A significant change in shortening fraction values for the left ventricle in recipient fetuses and the right ventricle of in the donors was observed during a 7-day follow-up. Conclusions: Comparison of the cardiac parameters of donors and recipients revealed significant differences in Tei-indices during the entire follow-up period. The group with Quintero’s I stage TTTS included 74% of recipient fetuses with abnormal Tei-Index values for the right ventricle (mean 0.53).

Objectives: This prospective study aimed to assess the effectiveness of foramen ovale examination in classifying prenatal hypoplastic left heart syndrome (HLHS) in accordance with the new classification groupings for congenital heart defects. Material and methods: The analysis included 145 fetuses with HLHS, diagnosed and monitored between 2008 and 2015 in Prenatal Cardiology Department at Polish Mother’s Memorial Hospital Research Institute in Lodz. The main criteria for classifying our study population into three sub-groups was was the presence of a foramen ovale restriction, which we diagnosed by evaluating the diameter and blood flow through the foramen ovale. Of the total group, 73.8% (n = 107) were classified as severe planned, 24.1% (n = 35) as severe urgent, and 2.1% (n = 3) as the severest group. Results: Comparing the severe planned and the severe urgent HLHS groups showed: gestational age of delivery 38 vs 38 weeks respectively (p = 0.45); cesarean delivery 62% vs 79.2% (p = 0.15); neonatal birth weight 3110 g vs 2985 g (p = 0.2); Apgar score 9 vs 9 points; survival rate 65.8% vs 61.9% (p = 0.8); and hospitalization 38 vs 46.5 days (p = 0.059). Prenatal qualification for the group of severe urgent HLHS was characterized by 100% sensitivity, 80.6% specificity and a low posi- tive predictive value of 9.5%. Conclusions: 1. Prenatal qualification into the group of severe urgent CHD based on the features of foramen ovale was characterized by high sensitivity, a satisfying specificity and a low positive predictive value. 2. Prenatally diagnosed foramen ovale restriction may be a predictor of longer hospitalization, but not of a need for an urgent Rashkind procedure. 3. New classifications of CHDs allowed clinicians to determine prognoses and to plan optimal multi-specialized care which resulted in similar outcomes between the severe planned and severe urgent HLHS groups.

Background: Ductus venosus is the fetal blood vessel connecting the abdominal portion of the umbilical vein with the inferior vena cava. Numerous studies have confirmed the important role of this vessel in fetal circulation. There are, however, cases when finding the ductus venosus during an ultrasound examination is impossible. Objective: The objective of the study was to assess the fate of fetuses with known ductus venosus agenesis and its severity in fetal life. Material and methods: 17 fetuses from singleton pregnancies with agenesis of the ductus venosus were observed and followed up. Results: A total of 3 intrauterine deaths, preceded by fetal hydrops and signs of heart failure, were observed in the study group. One newborn required cardiac care after birth. In the majority of cases with ductus venosus agenesis, where no accompanying developmental anomalies were found, prognosis for the fetus and the newborn was good. Conclusions: Cases of ductus venosus agenesis should be directed to and followed up in referral centers, where adequate diagnostic and therapeutic procedures can be undertaken.

Twin Reversed Arterial Perfusion (TRAP) sequence complicates about 1% of all monochorionic twin pregnancies and about 1 to 35000 of all pregnancies. It involves an acardiac twin whose structural defects are incompatible with life, and an otherwise normal "pump" co-twin. As the blood flow in the acardiac twin is reversed, it keeps on growing owing to the oxygenated blood from the co-twin. Here we report a case of monochorionic, diamniotic twin pregnancy after ICS/-ET complicated with TRAP sequence, diagnosed at 11 weeks of pregnancy The unusual finding in this case was the residual heart in the so called acardiac twin. Gradually the normal twin developed signs of hemodynamic compromise. Reversed a-wave in ductus venosus was observed. The acardiac twin showed subcutaneous oedema. On 24 November 2011 a successful interstitial ultrasound-guided laser coagulation was performed at 16 weeks of gestation. 17G needle and 0.6 mm laser fibre were used. The needle was introduced into the pelvic region of the acardiac twin through the abdominal wall. A series of laser bursts lasting 5-10 seconds were fired, until cessation of blood flow in the pelvic vessels and umbilical cord of the acardiac twin was confirmed using colour Doppler. The course of the intervention was uneventful. Routine steroid therapy was administered at 27 weeks of gestation. At 32 weeks the patient was hospitalized and oral antibiotics were administered due to premature rupture of the membranes and suspicion of intrauterine growth retardation of the pump twin. The patient delivered spontaneously at completed 33 weeks of pregnancy (weight 1805g, Apgar 10). After the delivery a stage 2 intraventricular hemorrhage and jaundice were observed in the neonate. Phototherapy was administered and the mother and the child were eventually discharged from the hospital, both in good general condition. Since then, two more successful interstitial laser coagulations in TRAP sequence were performed in our institution. The essence of the treatment of TRAP sequence is cessation of the blood flow from the pump to the acardiac twin. Fetoscopic cord ligature or coagulation, and laser or radiofreqency ablations of the acardiac twin vessels, are the possible methods of intervention. The interstitial laser coagulation of the acardiac twin is less invasive than fetoscopic umbilical cord coagulation, as the outer diameter of the 17G needle is much smaller. A meticulous comparison of these methods would require a randomised study but at 16 weeks of MCDA twin pregnancy interstitial laser coagulation seems to be the method of choice. The outcome of the procedure and possible treatment options in case of TRAP together with the review of literature, are presented in the article.

There is no information about an effect of pethidine labor analgesia on newborn vital signs in the first hours after the delivery.The aim of the study was to assess changes in heart rate, blood pressure and oxygen saturation during the first 24 hours of life in neonates born after using pethidine for labor analgesia.55 full-term neonates, 34 from intramuscular pethidine labor anesthesia in doses 50-100 mg and 21 born to mothers without any pharmacological form of anesthesia, were studied. Heart rate, oxygen saturation and blood pressure (SBP and DPB) were monitored using a Nellcor Oxi Max monitor N5500 (Tyco Healthcare), and recorded at 1, 6, 12 and 24 hours.No significant differences in the heart rate (144; 139; 141; 142,5 versus 142; 140,5; 138; 141 beats/minute), oxygen saturation (97%; 98%; 98%; 98,5%; versus 98%, 98%, 98%, 98%), SBP (66,5; 67; 66; 66,5 versus 68,5; 65; 64; 64,5 mmHg) and DBP (33,5; 35; 37; 40 versus 34; 32; 32; 38 mmHg) at 1, 6, 12 and 24 hours between pethidine and controls groups were found.Intramuscular pethidine analgesia during the first stage of labor in doses 50-100 mg does not significantly modify the oxygen saturation, heart rate and blood pressure in infants during the first 24 hours of their life.

Prenatal aortic valvuloplasty is performed only in few perinatal centers in the world. Critical aortic stenosis which can lead to hypoplastic left heart syndrome or severe fetal heart failure with nonimmune hydrops is an indication for this procedure. Prenatal intervention can change the natural course of the disease. Authors present the first successful fetal balloon aortic valvuloplasty in Poland. It was performed in a 29-week fetus with critical aortic stenosis, severe impairment of left ventricular function, heart failure and fetal hydrops. After successful intervention, without any complications, left ventricular function and fetal condition improved gradually Effective fetal intervention was possible after few months of preparation and building a team of specialists. This is the first successful fetal cardiac intervention in Poland, which opens the way to the new era of fetal cardiology and hopefully will lead to improve results in children with this critical heart defect.

Cardiotocography (CTG) is routinely used in obstetric units to monitor fetal well-being during pregnancy and labor Nevertheless the use of CTG is limited in cases of fetal arrhythmia, because it truncates the FHR if faster than 210 bpm and slower than 50 bpm. In fetal arrhythmias, with the heart rate between 50 bpm and 210 bpm, CTG may be nonconclusive, difficult to interpret and should not be taken into consideration when making the decision to end the pregnancy especially when it is premature. Until now the usefulness of CTG in the fetal arrhythmia has not been sufficiently described. The following study evaluates typical cases of fetal arrhythmia diagnosed by fetal echocardiography with corresponding cardiotocography and reviews the decision that had been made in each case.

Cardiac defects, the most common forms of congenital defects, are found in 3-8 of every 1000 pregnancies. Currently only 15-30% of CHD in newborns is detected prenatally. There are different strategies to increase the prenatal detection of cardiac abnormalities. Nuchal translucency screening and ductus venosus blood flow have been suggested to be useful methods of identifying cardiac anomalies in chromosomally normal fetuses.To examine the association between nuchal translucency thickness and ductus venosus blood flow between 11-13.6 week of pregnancy and CHD in chromosomally normal fetuses.Patients with singleton pregnancies at 11 to 13.6 weeks of gestation were recruited to undergo nuchal translucency sonography. The prevalence of major cardiac defects was determined and the utility of screening for nuchal translucency thickness including sensitivity, specificity, and positive and negative predictive values, were calculated for the NT thickness cut off points of the 95th and 99th centile for CRL. Ductus venosus Doppler ultrasound blood flow velocity waveforms were obtained at 10-13.6 weeks gestation.4720 gestations were analyzed, of which 13 newborn infants had CHD. The incidence of major CHD increased with increasing NT. Sensitivity specificity and positive predictive values were 45.4%, 92% and 1.5% at 99.8th percentile, and 25%, 98.5%, 3.2% and 99.8% at 99th percentile. Reverse or absent flow during atrial contraction was observed in 8 out of the 13 (61.5%) chromosomally normal fetuses with CHD.Measurement of fetal nuchal translucency thickness and ductus venosus blood flow at 11-13.6 weeks of pregnancy is a sensitive method of screening for CHD. The prevalence of CHD increases with increasing fetal NT and abnormal ductus venosus blood flow. Increased NT or abnormal ductus venosus blood flow is a strong indication for fetal echocardiography.

Ebstein's malformation is a rare congenital cardiac defect characterized by an abnormal formation and/or displacement of the leaflets of the tricuspid valve. Prognosis for a neonate is poor in case of cardiomegaly due to coexistence of lung hypoplasia. This paper presents a case of a fetus with Ebstein's malformation with massive cardiomegaly (HA/CA = 0.62) in a 27-year-old patient in her first pregnancy. The cardiac defect was diagnosed in the 22nd week of pregnancy. Due to the fact that the patient decided to continue her pregnancy, and taking into consideration single reports of transplacental Digoxin therapy an attempt to apply Digoxin therapy was made. The mother and the fetus were monitored in two centers, in Rzeszów and in Łódź. In the course of a 12-week transplacental therapy, 8 fetal echocardiography examinations were performed and the following parameters improved: HA/CA (0.62-0.5), CVPS (5/10-7/10) SF RA (0%-11%), SF RV (18%-28%). There was also a conversion of the oxygen test from negative to positive, which seems to document that prevention of the lung hypoplasia was achieved. The neonate died on the 8th day of postnatal life before a cardiac surgery attempt.

To assess the possibility of foetal circulatory system evaluation between 11+0 to 13+6 weeks of gestation in a reference perinatal cardiology centre.A prospective study was conducted between January 2004 and June 2008 in patients admitted to the reference perinatal cardiology centre for a foetal echocardiographic examination. 1170 foetuses were examined: 31 in 2004, 167 in 2005, 310 in 2006, 406 in 2007 and 262 in the first half of 2008. All foetuses had early echocardiography performed during 11-13+6 weeks of gestation, following the Foetal Medicine Foundation guidelines. The examination included: position and size of the heart, 4-chamber view and outflow tracts evaluation. The flow through ductus venosus, atrio-ventricular and arterial valves were assessed with colour and pulsed Doppler. 982 patients with confirmed normal heart anatomy in the second trimester were further analysed.Mean maternal age was 30 years. 237 (20%) patients were35 years old. Mean CRL (crown rump length) was 65 mm. 4-chamber view was obtained in 933 foetuses (95%) and outflow tracts in 813 (83%) cases. Diagnostic flow through the tricuspid valve was detected in 894 (91%) foetuses.Early foetal echocardiography is available in a reference perinatal cardiology centre since 11th week of gestation, in most cases with transabdominal probe. Possibility of the foetal heart anatomy evaluation increases with gestational age. Only patients from the high risk group (i.e. previous child with a major cardiac defect, diabetes mellitus, monochorionic pregnancy) and foetuses with increased NT should be examined. In every case, a control echocardiographic examination in the second trimester must be performed.

To establish the normal range of embryonic heart rate (EHR) and foetal heart rate (FHR) at 6(+0) to 11(+6) weeks of gestation, to evaluate the risk of pregnancy loss depending on EHR and FHR values and to establish if checking of FHR with the use of M-mode method is possible in different levels obstetric departments.Transvaginal or transabdominal ultrasound using M-mode in 255 singleton pregnancies. Maternal age varied between 16 and 44 years (mean 29 +/- 5 years). There were 67% primigravidas. Gestational week was established on the basis of CRL measurements. Demographic factors, obstetrical history and follow-up were collected. Data was statistically reviewed.FHR varied between 47 and 192 bpm (mean 154 +/- 26 bpm). At 6 weeks, mean EHR was 116 +/- 21 bpm, then slowly increased, reaching mean 172 +/- 9 bpm at 10 weeks. At 11 weeks the mean FHR achieved the level of 165 +/- 7 bpm. The difference was statistically significant. The r-correlation ratio between FHR and the gestational week was 0.58. In case of 7 embryos (2.75%) at 6.1 to 8.1 weeks of gestation slow FHR was noted (100 bpm). The scan performed 7-10 days later revealed miscarriages in all cases.EHR and FHR in the first trimester depends on gestational week. It increases since 6 to 9 weeks and decreases after 10 weeks. The highest values of FHR are observed between 9 and 10 weeks of gestation. The risk of early pregnancy loss increases significantly in case of detecting slow FHR. FHR can be checked by M-mode methods using any kind of ultrasound machine.

to confirm that fetal echocardiography is indeed possible in late first trimester and that it improves the standard of the so-called "genetic" ultrasound scan.Early echocardiography was performed in 75 fetuses from high and low risk pregnancies. All fetuses underwent echocardiography examination in 18-22 weeks of gestation and established follow up.The most suitable method of visualization seems to be transabdominal examination, between 13.0-13.6 weeks of gestation, an transvaginal one, between 12.0-12.6 weeks of gestation, with 90% effectiveness. In researched group of 75 fetuses (with established follow up) there were four heart defects (5.3%). Three of them were diagnosed before 14th week of gestation. One case (tetralogy of Fallot) was overlooked. There were two false positive diagnosis verified at 20th week of gestation.Early echocardiography, especially between 12.0-13.6 weeks of gestation, is a possible and valuable method of diagnosis. Reference evaluation should be performed between 18 and 22 weeks of gestation. In cases with suspected anomalies karyotyping is recommended. Congenital heart disease diagnosed at late first trimester should be treated as the next potential marker of genetic disorder.

In our referral center, 14,481 fetal echocardiography examinations were performed in 10,077 fetuses, in years 1994-2006. Fifty four fetuses presented cardiomegaly HA/CA0.6. There was one single survivor whose medical history is presented. Fetal cardiomegaly was detected by obstetrical ultrasound screening. In tertiary center HA/CA was evaluated as the following: 0.5 at 32 wks and 0.65 at 36 wks. In addition to cardiomegaly, pulmonary stenosis/atresia, dysplastic tricuspid valve with massive regurgitation were diagnosed. Digoxin was administered transplacentally for 33 days and, additionally, 30 min. oxygen was provided by mask for pregnant woman, 3 times per day. Spontaneous labour took place at 38 wks, with 3100 birth weight and 9 Apgar score. The newborn baby had only temporary tachypnoe, had a planned postdelivery therapy including prostin and cardiacsurgery and was discharged home at the age of 4 weeks in a good clinical condition. This is the first case in our institution of such massive cardiomegaly who did survived the neonatal period. The possible beneficial effects of transplacental digoxin and oxygen therapy are discussed, as well as fetal echocardiography monitoring using HA/CA and pulmonary venous Doppler flow.

To assess myocardial performance index (Tei index) for left and right ventricle in fetuses at 11.0 to 13.6 week of gestation.Flow velocity waveforms of mitral, tricuspid, aortic and pulmonary valves were obtained. The Tei index for the left ventricle (Tei LV) was calculated in 55, and for the right ventricle (Tei RV) in 27 fetuses.The value of Tei LV ranged from 0.28 to 0.59, mean 0.41 +/- 0.08, and for Tei RV from 0.23 to 0.56, mean 0.37 +/- 0.11. There was no statistically important correlation either between Tei index and both ventricles or gestational age and fetal heart rate. The possibility to measure Tei index increased with the progress of the pregnancy. There remains a significant correlation between Tei LV and Tei RV values.Tei index may be useful for the assessment of fetal myocardial performance in the first trimester of pregnancy. Tei index is independent of gestational age and fetal heart rate. It is easier to measure the Tei index for the left ventricle than for the right one.

Uterine blood flow restriction and placental insufficiency can cause intrauterine grow restriction. Permanent hypoxia triggers compensatory mechanisms to pro-tect vital organs. Increased placental resistance and constriction of the fetal pe-ripheral vessels, as evidenced by blood redistribution and increased right ven-tricular afterload and end-diastolic pressure lead to increased pulsality in pre-cordial veins. Doppler flow analysis of the IVC allows the indirect estimation of the fetal heart function.The aim of the study was to compare the Doppler indices in IVC in growth restricted and normal fetuses.The authors found that for the normal group PVIV, PIV and S/D de-creased with advancing gestation. However in comparision in IUGR group these parameters were substantially higher.The improvement of maternal and fetal Doppler techniques allows us to distinguish the subgroups of IUGR fetuses with the uteroplacental insufficiency that will have an increased perinatal morbidity and mortality. Alterations in the venous blood velocity waveforms have a more precise relationship with the risk of adverse perinatal outcome than changes in the arterial blood flow usually recognized relatively early in placental function disorders.

Diabetic pregnancy cause a lot of complications where fetal malformation is one of the most serious. Cardiac defects are besides the neural tube ones the most often in this group of pathology. Lack of pregnancy planning and thanks to it hyperglycemia during conceptive period and early embryogenesis increases the risk of fetal defect. We describe some typical cardiac malformation and functional disturbances connected with fetal heart. In our research we show the basic scheme of obstetrical fetal echocardiography and some common diagnostic problems we meet during our examinations. In conclusion references were reviewed which described the new approach for clinical assessment of the fetal heart like 3D and STIC; and the early diagnostic fetal echocardiography turn of the 1st and 2nd trimester.

The ductus venosus plays an important role in the oxygenated blood supply from the placenta directly to the fetal heart. Uterine blood flow restriction and placental insufficiency can cause intrauterine grow restriction. Permanent hypoxia triggers compensatory mechanisms to protect vital organs. Increased placental resistance and constriction of the fetal peripheral vessels, as evidenced by blood redistribution and increased right ventricular afterload and end-diastolic pressure lead to increased pulsatility in precordial veins. Doppler flow analysis of the DV allows the indirect estimation of the fetal heart function. Because it is not always possible to achieve correct ultrasound beam insonation there have been attempts to use angle-independent indices. The aim of the study was: to compare the Doppler indices in DV in growth restricted and normal fetuses.208 women were analyzed: 89 women between 22-42 weeks of pregnancy complicated by IUGR and 119 with normal pregnancy as a control group. Ultrasound examination using pulse and color Doppler was performed and PVIV, PIV, PLI and S/D ratio were estimated.The authors found that for the normal group PVIV, PIV, PLI and S/A decreased with advancing gestation. However in comparison in IUGR group these parameters were substantially higher.The improvement of maternal and fetal Doppler techniques allows us to distinguish the subgroups of IUGR fetuses with the uteroplacental insufficiency that will have an increased perinatal morbidity and mortality. Alterations in the venous blood velocity waveforms have a more precise relationship with the risk of adverse perinatal outcome than changes in the arterial blood flow usually recognized relatively early in placental function disorders.

To evaluate fetal heart anatomy in the late first and in the early second trimester.The study included 75 fetuses between 11 and 19 weeks' gestation. Exams were performed using transabdominal or transvaginal probes.The proportion of cases successfully visualized to all cases in particular week of pregnancy was following: 11 week--0/1 (0%), 12--1/1 (100%), 13 week--1/1 (100%), 14--18/23 (79%), 15--6/9 (67%), 16--23/27 (86%), 17--4/5 (80%), 18--6/6 (100%), 19--2/2 (100%). In 11 weeks' gestation two ventricles and two atrias could be imaged. Anatomy was seen from 12 weeks' gestation with transvaginal and from 13 weeks' gestation with transabdominal transducers. Two tricuspid regurgitations were detected. The interventricular septum was the most difficult structure to visualize in all cases. The grey scale alone was not sufficient for accurate examination of the heart and it was necessary to use colour Doppler to confirm normal forward flow to both ventricles and to identify outflow tracts.1. Successful visualization of the heart in early pregnancy is possible from 12 weeks' gestation with transvaginal and from 13 weeks' gestation with transabdominal probe. 2. Fetal echocardiography between first and second trimester should lead to better understanding of fetal hemodynamics in normal and abnormal fetuses and help to introduce new therapeutic treatment in some cases.

We have reported twin pregnancy complicated by uncommon "twin reversed arterial perfusion" syndrome. Ultrasound scan at 27th week of gestation revealed one normal foetus and the second one "acardiac" with severe malformations. Since the cardiac failure of the first twin was observed, the digitalis were administered till the end of pregnancy. The pregnancy was terminated at 31st week by caesarean section. We succeed in delivering one healthy newborn, which was possible by appropriate management including elective termination, observation (ultrasonography and cardiotocography) and nonsurgical intervention (digitalis).

39 normal fetal heart examinations were evaluated since 20 week of gestation to term, and Doppler blood flow was analysed for mitral and tricuspid valves. The measurements were done always in good 4 chamber view and qualitative and quantitative analysis were performed, in terms of describing E and A waves and maximal velocity against gestational age. In all of the cases between 20 and 34 weeks of gestation there were type EA Doppler waveform, and since 35 week of gestation there was also type E = A. There were only 2 cases with type EA, both near term. This Doppler waveform may depends on maturity of the fetal myocardium. The maximal velocity for the atrio-ventricular valves did not correlated with gestational age. The average max value for mitral valve was 43 +/- 10 cm/s and for tricuspid valve 50 +/- 11 cm/s (p0.01).

Doppler data have been analysed in 49 cases for aortic valve and 35 cases for pulmonary valve. For both valves V max, V mean, Aortic Flow and Pulmonary Flow were measured and compared with gestational age.V max A = 0.85 +/- 0.23 m/s, V max P = 0.72 +/- 0.14 m/s, (p0.01); V mean A = 0.28 +/- 0.08 m/s, V mean P = 0.24 +/- 0.06 m/s, (p0.02); A Flow = 699 +/- 285 ml/min, P Flow = 740 +/- 310 ml/min, and 275 +/- 100 ml/min/kg for aortic valve and 322 +/- 120 ml/min/kg for pulmonary valve (p0.05). There was statistical significant correlation between aortic and pulmonary flow and gestational age and there was no correlation between max velocity and gestational age for these valves.

Magnetocardiography, phonocardiography, polycardiography and blood flow analysis based on Doppler phenomenon are described discussing the importance of these methods in fetal monitoring in pregnancy and labour.