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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2013; 23(03): 262-265
DOI: 10.4103/0971-3026.120266
Genitourinary and Obstetric Radiology

Increased fetal endocardial echogenicity mimicking endocardial fibroelastosis following maternal organophosphorus poisoning and its complete regression in utero

Karippaliyil Balakumar
Department of Ultrasonography, Balku′s Scan, PVS Hospital, Calicut 2, Kerala, India
,
Kannan Misha
Department of Ultrasonography, Balku′s Scan, PVS Hospital, Calicut 2, Kerala, India
,
Karippaliyil Milind
Department of Ultrasonography, Balku′s Scan, PVS Hospital, Calicut 2, Kerala, India
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

Fetal endocardial fibroelastosis (EFE) has been diagnosed by antenatal ultrasonography in the past few years. A typical case of isolated endocardial fibroelastosis is illustrated here, in a fetus of 22 weeks of gestational age exposed to maternal organophosphorus poisoning at 20 weeks. No other structural cardiac or other systemic anomalies were detected in this fetus. The abnormal fetal echocardiographic features mimicking endocardial fibroelastosis completely regressed after 14 weeks and a normal full-term baby was delivered. Postnatal echocardiogram showed normal cardiac parameters. The diagnostic features mimicking EFE following maternal organophosphorus poisoning at 20 weeks of gestational age and the subsequent complete reversal of these changes after 14 weeks of diagnosis are reported for the first time in the literature.

Keywords

Fetal anomaly - fetal cardiac anomaly - fetal cardiomyopathy - fetal endocardial fi broelastosis - fetal echocardiography - fetal organophosphorus poisoning


Publication History

Article published online:
30 July 2021

© 2013. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 DeVore GR. Pulsed Doppler examination of the fetal heart. In: Goldberg BB, McGahan JP, editors. Atlas of Ultrasound measurements. 2 nd ed. Philadelphia: Mosby Inc./Elsevier; 2006.
  • 2 Friedman D, Buyon J, Kim M, Glickstein JS. Fetal cardiac function assessed by Doppler myocardial performance index (Tei index). Ultrasound Obstet Gynecol 2003;21:33-6.
  • 3 Gupta RC. Carbofuran toxicity. J Toxicol Environ Health 1994;43:383-418.
  • 4 Sax NI. Dangerous properties of industrial materials. In: Sax NI, Feiner B, editors. Dangerous properties of industrial materials - Volume 1. 6 th ed. Van Nostrand Reinhold Co, New York; 1984. p. 1152-3.
  • 5 Ameno K, Lee SK, In SW, Yang JY, Yoo YC, Ameno S, et al. Blood carbofuran concentrations in suicidal ingestion cases. Forensic Sci Int 2001;116:59-61.
  • 6 Letteer CR. Endocardial fibroelastosis. Ann Intern Med 1953;38:573-82.
  • 7 Comas M, Crispi F, Gomez O, Puerto B, Figueras F, Gratacos E. Gestational age- and estimated fetal weight-adjusted reference ranges for myocardial tissue Doppler indices at 24-41 weeks′ gestation. Ultrasound Obstet Gynecol 2011;37:57-64.
  • 8 Cruz-Martínez R, Figueras F, Bennasar M, García-Posadas R, Crispi F, Hernández-Andrade E, et al. Normal reference ranges from 11 to 41 weeks′ gestation of fetal left modified myocardial performance index by conventional Doppler with the use of stringent criteria for delimitation of the time periods. Fetal Diagn Ther 2012;32:79-86.
  • 9 Rustico MA, Benettoni A, Bussani R, Maieron A, Mandruzzato G. Early fetal endocardial fibroelastosis and critical aortic stenosis: A case report. Ultrasound Obstet Gynecol 1995;5:202-5.
  • 10 Kahyaoglu I, Kahyaoglu S, Sut H, Onen S, Mollamahmutoglu L. Isolated fetal endocardial fibroelastosis diagnosed and terminated at 22 weeks of gestation: A case report. Perinat J 2010;18:109-12.
  • 11 Dordevic, Vujic A, Jovanovic B, Dordevic G, Sazdanovic M, Sazdanovic P. Neonatal outcome following exposure to organophosphorus pesticides. Arch Biol Sci Belgrade 2010;62:1-8.
  • 12 Raboisson MJ, Fouron JC, Sonesson SE, Nyman M, Proulx F, Gamache S. Fetal Doppler echocardiographic diagnosis and successful steroid therapy of Luciani-Wenckebach phenomenon and endocardial fibroelastosis related to maternal anti-Ro and anti-La antibodies. J Am Soc Echocardiogr 2005;18:375-80.