Cardiac function monitoring of fetuses with growth restriction

• Published in: European journal of obstetrics & gynecology and reproductive biology Vol. 110; no. 2; pp. 159 - 163
• Main Authors: Figueras, Francesc, Puerto, Bienvenido, Martinez, Josep M, Cararach, Vicenç, Vanrell, Juan A
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 10.10.2003; Elsevier
• Subjects: Adult; Apgar Score; Biological and medical sciences; Birth Weight; Cesarean Section; Diastole; Diseases of mother, fetus and pregnancy; Female; Fetal cardiac function; Fetal growth restriction; Fetal Growth Retardation - physiopathology; Fetal Heart - physiopathology; Fetal Monitoring; Gestational Age; Gynecology. Andrology. Obstetrics; Humans; Hydrogen-Ion Concentration; Logistic Models; Longitudinal study; Management. Prenatal diagnosis; Medical sciences; Middle Cerebral Artery - embryology; Middle Cerebral Artery - physiopathology; Pre-Eclampsia - complications; Pregnancy; Pregnancy. Fetus. Placenta; Pulsatile Flow; Systole; Third trimester; Ultrasonography, Doppler; Umbilical Arteries - physiopathology; Pregnancy; Fetal cardiac function; Third trimester; Fetal growth restriction; Longitudinal study; Sonography; Human; Intrauterine growth retardation; Pregnancy disorders; Arantius canal; Middle cerebral artery; Umbilical artery; Duplex ultrasonography; Prospective; Heart rate; Left heart; Fetal growth restriction: Fetal cardiac function: Pregnancy; Fetal diseases; Surveillance; Follow up study; Medical imagery; Fetus; Monitoring
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/S0301-2115(03)00123-4

Objective: To describe the time sequence of changes in cardiac function in intrauterine growth restriction. Study design: This was a prospective longitudinal study on 22 singleton pregnancies with growth-restricted fetuses. Pulsatility indices of fetal arterial and venous Doppler waveforms, systolic peak velocity in the aorta and pulmonary artery, right and left ventricular shortening fraction and atrioventricular flow E/A ratio were assessed at each monitoring session. Logistic regression was used for modeling the probability of abnormality of a variable in relation to the time interval before delivery. Trends over time were analyzed by Mann–Withney U-test. Results: Umbilical artery pulsatility index was the first variable to become abnormal, followed by the middle cerebral artery, right diastolic indices (right E/A, ductus venosus), right systolic indices and, finally, both diastolic and systolic left cardiac indices. Conclusion: We have found an earlier and more pronounced right than left and diastolic than systolic fetal cardiac function deterioration in growth restricted fetuses monitored longitudinally.