Fetal Heart: Screening, Diagnosis and Intervention Milan Stanojevic, Cihat Sen
INDEX
Page numbers followed by f refer to figure, and t refer to table
A
A wave 144
Acquisition angle 193
Acquisition plane 193
Acquisition time 193
Adenosine 241
Alagille syndrome 247, 248, 251, 264
Alcohol 74, 251
American Academy of Pediatrics 280
Amiodarone 238, 240, 241, 244
Amphetamines 223
Anemia 223, 232, 235
Aneuploidy, overall rate of 254t
Anomalous pulmonary venous connection 118
Antiarrhythmic drugs 238t
Antibodies, autoimmune 21
Antiepileptic medications 251
Antihistaminic 232
Anxiety 223
Aorta 44, 56, 62, 63, 89, 195f, 202204, 212215
ascending 58, 64, 75, 77, 80, 83, 92, 95, 99, 101, 104106, 109, 111, 114
atretic 89
coarctation of 27, 48, 60, 63, 66, 69, 71, 7476, 110, 252255, 262, 264, 269, 281
critical-severe coarctation of 59
descending 58, 64, 110, 114, 194f, 202204, 206, 208215
interruption of 63, 66, 69, 76
maximum velocity of 147t
outflow 195f, 196
overriding 95f
pulmonary window 70
wall of 45f
Aortic annulus 64
Aortic arch 22, 56, 62, 63, 107, 110, 113, 115f, 173, 202204, 206, 208211, 211f, 212, 213, 213f, 215
anomalies 53
color Doppler sonography of 23
double 48, 59, 63
hypoplasia of 279
interrupted 48, 59, 60, 71, 75, 113, 114f, 250, 254, 264, 270
right 48, 98, 115, 116f, 210, 250
view, evaluation of 23
Aortic coarctation 48, 82f, 101f, 111f, 261
severe 48
Aortic isthmus 172
color flow of 112f
small 110
Aortic override 96
Aortic pulmonary valve stenoses 53
Aortic sac 3
Aortic stenosis 9, 26, 48, 59, 63, 74, 75, 91, 107, 108f, 109f, 252, 254, 261, 262, 264, 272
mild-to-moderate 59
supravalvular 264
Aortic valve 107, 110
Aortic width 64
Arch view 44
Arrhythmia 259, 291
Arrhythmic syndromes 232
Arterial pole 3
Arterial switch procedure 103
Arterial tortuosity syndrome 48
Arterial trunk, common 53, 74, 75
Arteriovenous anastomoses 179f
Artery
aberrant left subclavian 213
right pulmonary 58, 64, 203, 208210, 212, 213
Asphyxia 131, 148
Atresia 48, 63, 66, 67, 76, 107, 180, 269, 279
aortic 48, 59, 60, 71
duodenal 15
Atretic left inlet valve 81
Atretic mitral valve 89
Atria 34f, 43
evaluation of 19
Atrial appendages 63
Atrial chamber size 22
Atrial contraction 157
Atrial dilatation 227
Atrial ectopic beats 225
Atrial ectopy 226f, 227
perinatal management of 229
potential causes of 227
types of 226
Atrial flutter 229f, 236, 240
Atrial isomerism 234
Atrial muscle reentry 227
Atrial myocardium, enhanced automaticity of 227
Atrial natriuretic peptide 179
Atrial septal
aneurysm 48, 227, 232
defect 9, 27, 48, 59, 67, 74, 75, 77, 249, 252, 254, 260, 261, 264, 272, 286
excursion 103
tissue, lower rim of 43
Atrial septectomy 60
Atrial septum 22
Atrial ventricular M-mode tracings 228
Atrial wall, mechanical irritation of 227
Atrioventricular block 233, 239
management of 235t
perinatal management of 234
two-to-one 226f
Atrioventricular canal 1, 264
Atrioventricular conduction disease 227
Atrioventricular junction, evaluation of 20
Atrioventricular re-entry tachycardia 240
Atrioventricular septal defect 59, 61, 65, 67, 70, 7476, 253, 254, 261, 272, 286, 290
Atrioventricular valve 34f, 43, 140, 145f
color Doppler sonography of 23
regurgitation 181, 228
Atrium, enlargement of 48
Autosomal dominant 264
Autosomal recessive 264
Azygos 5
B
Balloon atrial septostomy 60
Baltimore-Washington infants study 259
Beta natriuretic peptide 162
Beta-mimetics 223
Bicuspid aortic valve 75, 110, 113, 252, 264
Bidirectional color flow 97f
Blood flow 167
direction of 125
patterns, biphasic 139
velocity 124
Blood viscosity 136
Blue spells 100
B-mode 218
Body mass index 13
Bovine jugular vein 295
Brachiocephalic artery 212, 213
Brachiocephalic vein 120
Bradycardia 233, 234
perinatal management of 234
Brain natriuretic peptide 179
Brugada syndrome 232
Bulbus cordis 3
C
Caffeine 232
excess consumption of 227
Carbamazepine 13
Cardiac anomaly 60, 248t
diagnostic ultrasound features of 65t
functional 235
Cardiac apex 19
Cardiac axis
abnormal 21
and situs 22
Cardiac conduction system, development of 4
Cardiac cycle 132, 139
Cardiac defects 247
Cardiac dysfunction 243
Cardiac function 140, 157
Cardiac malformations 256
Cardiac morphogenesis 1, 6
Cardiac myocytes 4
Cardiac position, abnormal 21
Cardiac remodeling 161
Cardiac structures, measurements of 58f
Cardiac tumor 48, 228, 232
Cardiac valves, development of 4
Cardiofaciocutaneous syndrome 264
Cardiomyopathy 88, 218, 227, 228, 234, 244, 254
arrhythmogenic right ventricular 232, 235, 241, 244
dilated 218, 219, 219f
hypertrophic 74, 75, 218, 220, 221f, 232, 235, 241, 244, 264
restrictive 218
Cardiosplenic syndromes 254
Cardiovascular adaptations 174
Cardiovascular adaption 167
Cardiovascular score 182
Cardiovascular system 178
pathophysiology of 159
physiology of 156
Carotid artery, left common 212, 213
Cavum septum pellucidum 134
Central nervous system 15, 74
abnormalities 233
Cesarean section 244, 286
Char syndrome 264
Choanal atresia 249
Cholestasis 247
Chorioamnionitis 223
Chorionic villus sampling 248
Circle of Willis 136f
Cleft palate 250
Coarctation 9, 279
aortic isthmus of 112f
Cocaine 223
Colobomata 249
Color Doppler 201
Color-box scale 22
Community-wide Fetal Cardiology Program 274
Congenital cardiac
anomalies 60t
malformations 15
Congenital heart
anomalies 74t
defect 76t, 140, 254t, 259, 261t
disease 9, 18, 26, 53, 59, 191, 210, 247, 251, 267, 268, 272, 282t, 286, 286t
antenatal diagnosis of 191
epidemiology of 9
mild 59, 59t
moderate 59t
severe 59, 59t
Congenital long QT syndrome 227
Conjoined intracardiac malformations 270
Connective tissue disorder 74
Conotruncal abnormalities 272
Conotruncal anomalies 255
Conotruncal defects 3
Conotruncal malformations 118
Conotruncal ridges 3
Conotruncal septum 3
Contractile appearance 89
Copy number variations 10, 251
Cor triatriatum 81
Cord blood 241
Coronary sinus 63, 169
connection 48
Costello syndrome 264
Cot death 235
Cyanosis, persistent 291
D
Delivery
decision 241, 242
place of 69, 78, 81, 84, 86, 89, 91, 94, 96, 98, 100, 103, 105, 107, 110, 113, 115, 117, 118
room 286
simulation 285
Diabetes mellitus 21, 74, 221f, 259
Diaphragmatic hernia 15
DiGeorge syndrome 270
Digoxin 237239
toxicity 238
Dilatation 108
Dioxins 251
Diverticulum of Kommerell 211213
Dizziness 238
Donor 183
bladder of 182
twin 181
Doppler
flow 181
index 160
physics 125f
signals 131
sonography 21, 133
ultrasound 124
Down syndrome 69, 264, 270
Ductal anomalies 48
Ductal arch 62, 63
view, evaluation of 23
Ductal flow, reversed 48
Ductus arteriosus 57, 58, 60, 64, 94, 96f, 111, 114f, 116f, 167, 175, 203206, 212, 213, 215
Ductus venosus 14, 29, 130, 130f, 136, 138f, 140f, 150f, 151, 167, 175, 182, 183, 210, 211
Doppler for screening of fetal heart defects 29f
peak systolic velocity index 144t
preload index 141t, 142
pulsatility index 143t, 185
triphasic blood flow pattern of 139f
waveform, abnormal 22
Duplication syndromes 264
Dysgenesis 5
Dysrhythmias 297
E
E wave 144
Ear anomalies 249
Ebstein's anomaly 48, 59, 61, 65, 67, 68, 73, 76, 86, 87f, 88f, 261, 270, 272, 278, 281, 286
Ebstein's malformation 299
Echocardiography 18
Edward syndrome 264
Electrocardiography 185
End-diastolic flow
absent 151, 183
reverse 183
Endocardial fibroelastosis 89, 90f, 108, 108f, 234
Enteropathy, protein-losing 291
Ephedrine 231
Erythropoietin 7
Extracardiac malformations 14
Extracorporeal membrane oxygenation 286
F
Facial anomalies 247
Fatigue 238, 239
Fetal 126, 259
abdominal situs, examination of 40f
anemia 147
predict severity of 138t
arrhythmia 230f
diagnosis of 223
management of 223
presentation of 224
atrial flutter 231f
atrioventricular block 233
bradycardia, management of 235t
cardiac disease 259
cardiac function 156
cardiac volume analysis 193
chromosomal anomaly 21
circulation 131
normal 168
complete atrioventricular block 231f
deaths 274
demise 130
distress 232, 233, 235, 243
echocardiography 15, 22, 28, 39, 191, 218, 267, 283
technique of 21
extracardiac anomaly 21
growth restriction 127, 159
head 197f
heart 37f, 140, 201
defects 29f, 31
examination 19, 21, 26, 27, 31, 33f, 34f, 39
failure 88
function, assessment of 158
malformation 271
normal 201, 202f210f
pathophysiology of 159
physiology of 156
rate 173, 223, 234, 243
hemoglobin 136
hydrops 21, 227, 259
hyperthyroidism 223
hypoxemia 132
indications 21
infection 243
irregular heart rhythm
investigation of 232t
management of 232t
lamb circulation 170f
medicine 241
myocardium 157
risk factors 14
situs, assessment of 38t
supraventricular tachycardia
diagnosis of 240t
management of 240t
tachycardia 236, 237
vascular system, development of 5
ventricular tachycardia, management of 243t
Fetoplacental compartment 130
Fiber orientation 157
Fibroblast growth factor 6
Flecainide 238, 239
level 241
Flow velocity wave 124
Fluorescence in situ hybridization 251
Fontan-type operation 292
Foramen ovale 22, 57, 83, 92, 120, 167, 175, 227
color Doppler sonography of 23
dependent
pulmonary circulation 60
systemic circulation 60
flap 19
restrictive 48, 59, 286
Foramen primum 2
Four-chamber view
abnormal 21, 271
apical 43
evaluation of 23
G
Gastrointestinal system 74
Genetic 10
abnormalities 69, 78, 81, 84, 86, 89
syndromes 15, 18
common 248t
Gestational age 160
Gray-scale sonography 20
Great arteries 104
congenitally corrected transposition of 48, 59
corrected transposition of 254
D-transposition of 269, 281, 286, 287
transposition of 9, 18, 27, 48, 53, 60, 62, 66, 67, 69, 70, 7476, 102, 253, 254, 261, 262, 269
Great veins 63
Great vessels 140
Growth restricted fetus 148, 149f, 150f, 159
management of 151t
Growth retardation 249
H
Harmonic imaging 22
Heart 196f, 272
anomalies 70t
block 233, 234
defects 249
dilated 219
discordant 36f
disease
functional 227, 232
structural 227, 234, 244
failure 291
field, primary 6
rate 42, 232, 235, 241, 244
abnormal 21
rhythm 42
abnormal 21
shape of 157
univentricular 254
ventriculoarterial connections of 22
Hematological system 15
Hemiazygos veins 5
Hepatic arteries 131
Hepatic dysfunction 291
Hepatic vein 140f, 202, 204206, 208, 209, 211, 215, 228
Heterotaxy 247, 256, 290
syndrome 118
High periconceptional blood glucose levels 12
Holme's heart 91
Holt-Oram syndrome 10, 249, 251, 264
Human cardiovascular system 1
Human chorionic gonadotropin 129
Hydantoin 74
Hydrops 220, 232, 233, 235, 243
fetalis 182
presence of 234
Hypercholesterolemia 251
Hyperthyroidism 243
Hypertrophy
biventricular 107
myocardial 48
right ventricular 98
ventricular 108, 181
Hypokinesia 108
Hypoplasia 279
aortic 46, 48
genital 249
left ventricular 83f
thymic 250
Hypoplastic left heart 59, 61, 71
complex 290
syndrome 12, 48, 57, 60, 65, 67, 68, 7476, 89, 90f, 118, 210, 215f, 247, 252, 254, 255, 261, 263, 264, 269, 272, 281
outcome of 290
Hypoplastic right heart 59, 74
syndrome 48, 215f
Hypothyroidism 238
Hypovolemia 223
Hypoxia 223
I
Iliac arteries, common 5
Iliac veins, common 5
In vitro fertilization 21
Infection 223
Inferior vena cava 5, 19, 41, 58, 63, 64, 118, 130, 130f, 138, 140f, 168, 201203, 206, 207, 209, 210, 215
Inlet valve, common 69
Innominate vein 203, 204, 206
Intact atrial septum 281, 286
Intact cardiac crux 20, 38
Intact ventricular septum 83, 92, 254, 286, 290
Interventricular septum 2, 22, 30, 43
Intrauterine growth
restriction 131
retardation 233
Ischemia 228
Isomerism 69
Isotretinoin 251
Isovolumetric contraction 157
time 185
Isovolumetric relaxation 156, 157
time 185
Isthmus 110
J
Jugular veins 5
K
Karyotype, normal 251
Kick count 240
Knock-out animal model studies 4
L
Left atrium 62, 63, 77, 80, 83, 85, 87, 90, 92, 95, 99, 101, 104106, 109, 111, 114, 120, 206208, 210, 211, 293
length 64
width 64
Left ventricle 58, 62, 63, 77, 78, 80, 83, 85, 87, 90, 92, 95, 99, 101, 104106, 109, 111, 114, 120, 202208, 211, 214, 215
double-inlet 48, 59, 61, 65, 67, 68, 76, 91, 92f, 252, 290
double-outlet 59
ejection time 185
length 64
myocardial performance index 185
width 64
Left ventricular
function, abnormal 181
outflow tract 22, 44, 81
evaluation of 20, 23
Legal stimulant medications or illicit drugs, maternal use of 227
LEOPARD syndrome 221
Lithium 21, 74
carbonate 13
Live births 274
Liver function tests 235
Long QT syndrome 228, 232, 233, 235, 241, 243, 244
Long-axis function-tissue Doppler imaging 182
M
Main pulmonary artery 64, 147t
bifurcation of 56f
Major aortopulmonary collateral circulation 94
Marfan syndrome 10
Marijuana 74
Maternal beta-blocker treatment 233
Maternal connective tissue disorder 233
Maternal lupus autoantibody titers 234
Mediastinum 74
upper 195f
Mesenchymal tissues 3
Metabolic disease 21
Metallic taste 238
Microdeletion 98
syndromes 264
Middle cerebral artery 131, 132, 135f, 138t, 151
resistance index, reference values of 137t
waveforms 182
Mitral atresia 59, 61, 73, 80f, 81, 82f, 83f, 254
Mitral regurgitation 75
Mitral stenosis 110
Mitral tricuspid
annuli tissue Doppler recordings 228
valves 157
Mitral valve 63, 110, 145t
Doppler inflow 183
prolapse 75
M-mode 218, 220, 228, 236, 243
Doppler
methods 234
technique 231f
echocardiography 21
Monitor cardiac function 243
Monochorionic twins 22
Monocusp valve 295
Monophasic blood flow pattern 146f
Multiplanar presentation 194f
Multiple malformation disorder 18
Muscular ventricular septal defect 80f
Musculoskeletal system 15
Musculus trabecula septomarginalis 43
Myocardial calcification 234
Myocardial dysfunction 234
Myocardial performance index 182, 185f
Myocarditis 227
Myocardium 169
function 181
Myocytes, moncontractile 4
N
Nausea 238
Nonconducted premature atrial contractions 233
Nonhydropic fetuses 237
Nonoptimal fetal position 33f
Noonan syndrome 10, 15, 221, 248, 249, 264
Nuchal translucency 11, 14, 22, 259, 271
O
Oligohydramnios 185
One-and-a-half ventricular repair 292
Outflow tract 63
development of 3
views 53
Oxygen
carbon dioxide 167
pressure of 171
P
Pain 223
Palliation 297
Partial anomalous pulmonary venous drainage 264
Parvovirus infection 219f
Patau syndrome 264
Patent ductus arteriosus 9, 27, 74, 75, 261, 264
Patent foramen ovale 80
Peak systolic velocity 134, 151
Pericardial effusion 22, 48, 88
Pericardial graft 295
Persistent truncus arteriosus 298
outcome of 298
Pesticides 251
Phenylketonuria 11, 21, 74, 259
maternal 12, 30
Phenytoin 13
Placenta 167
surface of 179f
Placental abruption 130
Placental dysfunction 148
Plastic bronchitis 291
Pneumonia, bacterial 298
Polyhydramnios 181, 185
sequence 182
Polyvalvular nodular dysplasia 75
Portal sinus 168
Portal vein 168
Power Doppler 201
Preeclampsia 130
prediction of 151
Pregnancy 260
multiple 259
outcome of 273f
terminations of 274
Premature atrial contraction 223, 225, 225f, 232
Premature ventricular contraction 228, 232
Prenatal detection rate 272t
Prenatal screening 270, 277, 282
Proarrhythmia 238
Prominent vagal tone 233
Prostaglandin
E 286
E1 288
infusion 94
E2 171
Protein, morphogenic 6
Pulmonary artery 3, 20, 39, 62, 63, 74, 77, 80, 83, 90, 92, 95, 99, 101, 105, 106, 109, 111, 114, 183, 195f, 197f, 202208, 211215, 228, 292
hypoplasia 48
left 58, 64
Pulmonary atresia 48, 59, 60, 72, 84f, 94, 95f, 96f, 254, 261, 269, 272, 281, 286
outcome of 292
Pulmonary semilunar valves 4
Pulmonary stenosis 26, 48, 59, 66, 67, 7476, 85, 91, 92, 93f, 98, 100, 101f, 180, 210, 211f, 254, 261, 262, 264, 272, 289
Pulmonary valve 4, 20, 92, 63
annulus 110
atresia 290
completely obstructed 94
syndrome, absent 48, 59, 75, 96, 97f, 254, 255
Pulmonary valvotomy 295
Pulmonary vein 34f, 63, 211, 228
abnormal connection of 48
color Doppler sonography of 23
left 120
Pulsatility index 124, 126, 129t, 151
Pulse repetition frequency scale 22
Pulse wave 228, 234, 243
Pulsed Doppler flow velocities 140
Q
QRS widening 238
QT prolongation 238, 239
Quintero stages 182
R
Regular cardiac rhythm 19
Regurgitation, aortic 75
Renal system 74
Renin-angiotensin aldosterone system 179
Restrictive ventricular septum 59
Retinoic acid 74
Retinoids 13, 21
Retrograde flow 94
Rhesus isoimmunization 131
Rhythm 219
Right atrium 58, 62, 63, 77, 80, 83, 85, 87, 90, 92, 95, 99, 101, 104106, 109, 111, 114, 120, 202211, 215
length 64
width 64
Right inlet valve regurgitation 69
Right ventricles 62, 63, 77, 78, 80, 83, 85, 87, 90, 95, 99, 101, 104106, 109, 111, 114, 120, 202206, 210, 211, 214, 215
double-outlet 12, 18, 30, 48, 53, 59, 66, 67, 69, 7476, 100, 253, 254, 269, 272, 281
length 64
width 64
Right ventricular function, abnormal 181
Right ventricular outflow tract 22, 44, 81, 99, 183, 292
evaluation of 20, 23
Rudimentary pulmonary valve leaflets 96
S
Sagittal ductal arch 56, 110, 113
Salbutamol 235
Scanning planes 69, 78, 81, 83, 86, 89, 102, 115, 116, 118
Selective serotonin reuptake inhibitors 13
Semilunar valve 146f
flow 22
peak velocities 182
Septal defect 68, 82f, 84f
Septal leaflet, displacement of 87f
Septum
primum 2, 43
secundum 2
Sick sinus syndrome 233
Single gene disorders 263, 264
Single ventricle 103, 279
complex 281
Sinus venosus types 59
Situs 40
abdominal 19
solitus 256
Sjögren syndrome 220, 233, 234, 259
Skeletal abnormalities 247
Sotalol 237239, 244
Spatial three-vessel view 202, 205f
Sphenoid bone 134
Stenosis
critical aortic 59, 60, 68, 90f, 108f
critical pulmonary 59, 60
mild-to-moderate pulmonary 59
peripheral pulmonary 264
artery 74, 75
severe 59
aortic 48, 59
pulmonary 59, 69
Stuck twin 131
Subclavian artery, left 114
Sudden cardiac death 235
Superior vena cava 3, 19, 39, 58, 63, 64, 82, 117f, 119f, 120, 169, 201205, 207213, 215, 228, 229f
Supraventricular tachycardia 88, 229f, 230f, 237
frequency distribution of 224f
perinatal management of 240
Systemic lupus erythematosus 233, 259
Systemic outflow obstruction 290t, 297
Systemic veins, color Doppler sonography of 23
Systolic dysfunction 181
T
Tachycardia 237f
atrial 236
atrioventricular 241
catecholaminergic polymorphic ventricular 232, 235, 241, 244
despite medication 241
Taussig shunt 297
Tei index 159, 161, 181, 184
Teratogen exposure 21
Terbutaline 231
Terfenadine 231
Tetralogy of Fallot 9, 18, 27, 48, 53, 59, 6669, 72, 7476, 98, 99f, 118, 247, 252254, 261, 262, 264, 269, 281, 286
outcome of 294
Thalami 134
Thalidomide 251
Thoracic aorta 131
Thoracic area, heart occupies third of 19
Thromboembolism 291
Thyroid function 243
Thyrotoxicosis, maternal 223
Time average maximal velocity 143t
Tissue 234
Doppler
imaging 159
method 230f
recording 230f
Tomographic ultrasound imaging 193, 194
Total anomalous pulmonary venous
connection 56, 59, 65, 67, 68, 71, 7476, 120f, 279
outcome of 293
return 252, 281
Toxins 260
Trachea 26, 44, 48, 116
Transannular valve 295
Transverse arch 113
Tricuspid 269
atresia 48, 61, 65, 67, 68, 72, 7476, 83, 84f, 85f, 247, 254, 261, 281
outcome of 296
atrioventricular valves 35f
dysplasia 48
regurgitation
mild-to-moderate 59
severe 59, 88, 88f
valve 63, 91, 145t
atresia 290
dysplasia 254
Ebstein's anomaly of 87f, 88f
Trimethadione 74
Trisomy 98, 248, 263
Truncus arteriosus 3, 12, 47, 48, 59, 63, 66, 69, 70, 76, 105f, 106f, 250, 253, 254, 264, 269, 272, 277279, 281, 286
Tumor, atrial 227
Turner syndrome 10, 89, 248, 263, 264
Twin
anemia-polycythemia syndrome 184
oligohydramnios 182
twin transfusion syndrome 178
placenta after laser ablation of 179f
U
Ultrasound 124, 192
Umbilical artery 151, 175, 182, 185
Doppler flow 131
Doppler studies 131
pulsatility index, reference values of 134t
resistance index, reference values of 133t
travel caudally 136
Umbilical vein 130f, 168, 175, 182
apex of 138f
Uterine artery 126, 151
Doppler waveform 127f
pulsatility index of 129t
resistance index of 128t
Uteroplacental compartment 126
V
Valproic acid 13
Valvar pulmonary stenosis, mild 9
Valvar regurgitation 182
Valvar stenosis, semilunar 56
Valve 63, 170
sparing total repair 295
Valvular stenosis, aubpulmonary 101
Vascular malformations 259
Vascular ring 48, 59
Vascular shunts 167
Vascular system development 1
Vein
ascending 120
right pulmonary 120
Vena cava 228
Ventricles 34f, 43, 48, 89
evaluation of 19
Ventricular dysfunction 228, 297
Ventricular dysrhythmia 236
Ventricular ectopic beats 228
Ventricular ectopy, perinatal management of 229
Ventricular end-diastolic volume 297
Ventricular morphology 22
Ventricular septal defect 9, 27, 46f, 48, 61, 65, 67, 68, 70, 7478, 79f, 80, 83, 101, 105, 105, 214, 249, 252254, 260, 261, 264, 272, 280, 286
large 59
small 59
Ventricular septum intact 20, 38
Ventricular systole 139
Ventricular tachycardia 243
perinatal management of 243
Ventriculoarterial discordance 297
Viral infection 148, 227, 259
Viral titers 234
Visual disturbance 238
Vomiting 238
W
Williams syndrome 248250
Williams–Beuren syndrome 264
World Health Organization 191
Z
Z-scores 22, 94
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Chapter Notes

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