Fetal Hiccups

June 15, 2011

The patient was a 38 year old G4 P3, 20w4d. I was doing an anatomic survey today. While I was looking at a long axis view of the fetal heart with color Doppler, the baby developed hiccups, and with each contraction of the fetal thorax (which was quite obvious) I could see an explosion of blue color representing blood going through the foramen ovale from right to left.

Title of image: Fetal Hiccups
Description of Ultrasound Video: The patient was a 38 year old G4 P3, 20w4d. I was doing an anatomic survey today. While I was looking at a long axis view of the fetal heart with color Doppler, the baby developed hiccups, and with each contraction of the fetal thorax (which was quite obvious) I could see an explosion of blue color representing blood going through the foramen ovale from right to left. The position of the heart placed the right atrium superior on my screen, so the blood was moving away from the transducer and the color was appropriate. It was the amount of color that surprised me, suggesting that a very large volume of blood was being squeezed through the foramen ovale when the thorax contracted.

A hiccup might be due to a spasm of the diaphragm, but I could clearly see the lateral fetal thorax cave inward very briefly and somewhat spasmodically.

I have never seen this before. Is it something that is known and happens? Do you suppose this happens in adults when we cough or sneeze? Not through the foramen ovale of course, but perhaps through one of the valves of the adult heart?

Joseph A Worrall MD RDMS

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