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© 2009 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 28:609-614 • 0278-4297

Embryonic Heart Rate as a Prognostic Factor for Chromosomal Abnormalities

Deniz Oztekin, MD, Ozgur Oztekin, MD, Fatma I. Aydal, MD, Sivekar Tinar, MD and Zehra H. Adibelli, MD

Department of Obstetrics and Gynecology, Aegean Obstetrics and Gynecology Training and Research Hospital, Izmir, Turkey (D.O., S.T.); Department of Radiology, Bozyaka Training and Research Hospital, Izmir, Turkey (O.O., Z.H.A.); and Department of Obstetrics and Gynecology, Izmir Can Medical Centre, Izmir, Turkey (F.I.A.).

Address correspondence and reprint requests to Deniz Oztekin, MD, Albayrak Mavisehir Evleri, Yali Mahallesi, 6525 Sokak 35, Daire 31, Karsiyaka, Izmir, Turkey., E-mail: dcoztekin{at}gmail.com

Objective. The purpose of this study was to evaluate the role of a slow embryonic heart rate in embryos before 7 weeks’ gestation as a marker in screening for chromosomal abnormalities. Methods. Fifty-seven embryos before 7 weeks’ gestation with slow heart rates were compared with 1156 embryos of the same gestational period with normal heart rates. Embryos that showed an increased risk of chromosomal abnormalities in the screening blood tests underwent invasive analysis for abnormal karyotype detection. Results. The rates of first-trimester death were 15.8% for pregnancies with slow embryonic heart rates (9 of 57) and 2.5% for those with normal heart rates (29 of 1156). Because of the increased risk of chromosomal abnormalities, amniocentesis was performed on 6 with slow embryonic heart rates and 61 with normal embryonic heart rates. After karyotype analysis, there were 2 fetuses with trisomy 21 in each group, which represented significantly higher percentage of embryos with trisomy 21 in the slow–heart rate group compared with the normal–heart rate group (P < .05). Conclusions. When a slow embryonic heart rate is detected before 7 weeks’ gestation, there is a higher likelihood of chromosomal abnormalities.

Key Words: embryo • fetus • first trimester • heart rate

Abbreviations: bpm, beats per minute • CRL, crown-rump length • CVS, chorionic villus sampling • NT, nuchal translucency

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