Search tips
Search criteria 


Logo of brheartjLink to Publisher's site
Br Heart J. 1992 December; 68(6): 580–585.
PMCID: PMC1025688

Correlation between echocardiographic and morphological investigations of lesions of the tricuspid valve diagnosed during fetal life


Objective—To assess the degree of agreement between the fetal echocardiographic and postmortem examination of hearts from fetuses with severe malformations of the tricuspid valve.

Design—A retrospective study to analyse echocardiographic recordings and make comparisons with postmortem findings.

Setting—Tertiary referral centre for fetal echocardiography. Institute for cardiac morphology.

Patients—19 cases shown to have severe malformation of the tricuspid valve by fetal echocardiography that died in the prenatal or neonatal period.

Main outcome measures—Correlations between morphology and measurements made at echocardiography and necropsy.

Results—The echocardiographic diagnosis was Ebstein's malformation in seven and tricuspid valvar dysplasia in 12 fetuses. These findings were confirmed in six and eight cases at necropsy. In one false positive diagnosis of Ebstein's malformation, necropsy showed dysplasia of the leaflets of the tricuspid valve without displacement. In four cases with the echocardiographic diagnosis of valvar dysplasia, necropsy showed displacement, the hallmark of Ebstein's malformation. Associated malformations that are known to worsen prognosis were predicted correctly by echocardiography. Taking the mean duration of four weeks between echocardiographic and postmortem investigations, both methods showed cardiomegaly causing lung hypoplasia, right atrial dilatation, and relative hypoplasia of the pulmonary trunk, morphometric factors that may be responsible for the poor outcome. Mostly good agreement existed between the echocardiographic and postmortem measurements if cases with an interval of more than eight weeks between the measurements were excluded.

Conclusion Fetal echocardiography was proved to be a reliable technique in differentiating the variants of tricuspid valvar disease, in diagnosing associated cardiac lesions, and in predicting quantitative factors that can define the subsequent outcome.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (2.2M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Allan LD, Chita SK, Sharland GK, Fagg NL, Anderson RH, Crawford DC. The accuracy of fetal echocardiography in the diagnosis of congenital heart disease. Int J Cardiol. 1989 Dec;25(3):279–288. [PubMed]
  • Sharland GK, Chita SK, Allan LD. Tricuspid valve dysplasia or displacement in intrauterine life. J Am Coll Cardiol. 1991 Mar 15;17(4):944–949. [PubMed]
  • Lang D, Oberhoffer R, Cook A, Sharland G, Allan L, Fagg N, Anderson RH. Pathologic spectrum of malformations of the tricuspid valve in prenatal and neonatal life. J Am Coll Cardiol. 1991 Apr;17(5):1161–1167. [PubMed]
  • Allan LD, Chita SK, Al-Ghazali W, Crawford DC, Tynan M. Doppler echocardiographic evaluation of the normal human fetal heart. Br Heart J. 1987 Jun;57(6):528–533. [PMC free article] [PubMed]
  • Allan LD, Crawford DC, Tynan MJ. Pulmonary atresia in prenatal life. J Am Coll Cardiol. 1986 Nov;8(5):1131–1136. [PubMed]
  • Paladini D, Chita SK, Allan LD. Prenatal measurement of cardiothoracic ratio in evaluation of heart disease. Arch Dis Child. 1990 Jan;65(1 Spec No):20–23. [PMC free article] [PubMed]
  • Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986 Feb 8;1(8476):307–310. [PubMed]
  • Becker AE, Becker MJ, Edwards JE. Pathologic spectrum of dysplasia of the tricuspid valve. Features in common with Ebstein's malformation. Arch Pathol. 1971 Feb;91(2):167–178. [PubMed]
  • Anderson RH, Silverman NH, Zuberbuhler JR. Congenitally unguarded tricuspid orifice: its differentiation from Ebstein's malformation in association with pulmonary atresia and intact ventricular septum. Pediatr Cardiol. 1990 Apr;11(2):86–90. [PubMed]
  • Silverman NH, Kleinman CS, Rudolph AM, Copel JA, Weinstein EM, Enderlein MA, Golbus M. Fetal atrioventricular valve insufficiency associated with nonimmune hydrops: a two-dimensional echocardiographic and pulsed Doppler ultrasound study. Circulation. 1985 Oct;72(4):825–832. [PubMed]
  • Roberson DA, Silverman NH. Ebstein's anomaly: echocardiographic and clinical features in the fetus and neonate. J Am Coll Cardiol. 1989 Nov 1;14(5):1300–1307. [PubMed]
  • Shiina A, Seward JB, Edwards WD, Hagler DJ, Tajik AJ. Two-dimensional echocardiographic spectrum of Ebstein's anomaly: detailed anatomic assessment. J Am Coll Cardiol. 1984 Feb;3(2 Pt 1):356–370. [PubMed]
  • Todros T, Presbitero P, Gaglioti P, Demarie D. Pulmonary stenosis with intact ventricular septum: documentation of development of the lesion echocardiographically during fetal life. Int J Cardiol. 1988 Jun;19(3):355–362. [PubMed]
  • Allan LD, Tynan M, Campbell S, Anderson RH. Normal fetal cardiac anatomy--a basis for the echocardiographic detection of abnormalities. Prenat Diagn. 1981 Apr;1(2):131–139. [PubMed]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group