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A Prospective Evaluation of Fetal Pericardial Fluid in 506 Second-Trimester Low-Risk Pregnancies

Obstetrics & Gynecology: December 1997
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Objective To measure fetal pericardial fluid in low-risk second-trimester pregnancies and to evaluate outcome for those with measurements greater than 2 mm.

Methods Five hundred and six women were referred for sonography between 16 and 25 weeks' gestation for common obstetric indications (dating, fetal survey, and placental location) unrelated to an increased risk of anomalies. All cases were evaluated with two-dimensional and M-mode real-time ultrasonography with the use of a mechanical sector transducer. The maximum distance of the fetal hyposechoic cardiac rim was recorded. We reviewed maternal and infant charts for those with measurements greater than 2 mm.

Results Median (range) maternal age was 25 (15–42) years. Median gravidity and parity were two (1–4) and one (0–11), respectively. Median estimated gestational age was 20.4 (16.324.9) weeks. Fetal pericardial fluid was seen in 360 of 506 (71%) fetuses. Of these 360 fetuses, the mean distance (± 2 standard deviation) of the fetal hypoechoic cardiac rim was 1.20 mm ± 0.91 mm (95% confidence interval 1.15, 1.25). Among the 506 cases, the maximum measurement was 3 mm. Ten of the 506 (2%) cases had measurements greater than 2 mm. None of these ten fetuses had a cardiac structural abnormality or arrhythmia, and perinatal outcome was unremarkable.

Conclusion During second-trimester fetal ultrasonographic examination, visualization of pericardial fluid up to 2mm in the fetus with current high-resolution technology is common and should not be regarded as pathologic.

Address reprint requests to: Donna S. Dizon-Townson, MD, Department of Obstetrics and Gynecology, Room 2B200, University of Utah Health Science Center, 50 North Medical Drive, Salt Lake City. Ut 84132; E-mail:

© 1997 The American College of Obstetricians and Gynecologists

During second-trimester ultrasonography, visualization of fetal pericardial fluid up to 2 mm is common.