Fetal cardiac alterations in the late‐onset growth‐restricted fetuses: A prospective case–control study

• Published in: The journal of obstetrics and gynaecology research 2022-02, Vol.48 (2), p.373-378
• Main Authors: Turkyilmaz, Gurcan, Turkyilmaz, Sebnem, Uygur, Lutfiye
• Format: Article
• Language: English
• Subjects: Case-Control Studies; Echocardiography; Female; Fetal Growth Retardation - diagnostic imaging; Fetal Heart - diagnostic imaging; Fetuses; Gestational Age; Humans; Infant; intrauterine growth restriction; MPI; Pregnancy; Prospective Studies; TAPSE; Ultrasonography, Prenatal
• ISSN: 1341-8076; 1447-0756
• DOI: 10.1111/jog.15114

Aim Fetal growth restriction (FGR) has significant consequences on cardiac functions. This study aims to evaluate cardiac functional parameters in late‐onset (FGR) fetuses and compare those appropriate for gestational age (AGA) fetuses. Material and Methods Fifty‐six singleton pregnancies were involved in this prospective case–control study. Delphi consensus was used to define late‐onset FGR. We compared the E/A ratio, left myocardial performance index (MPI) and tricuspid annular plane systolic excursion (TAPSE) in late‐onset FGR cases and gestational age‐matched AGA fetuses. Results Twenty‐eight late‐onset FGR and 28 AGA fetuses were enrolled. The mean gestational age in the late‐onset FGR group was 34.1 ± 2.3 weeks and 34.4 ± 2.1 in controls. The E/A ratio was 0.88 ± 0.09 in AGA fetuses, 0.79 ± 0.11 in the late‐onset FGR group, and significantly lower in late‐onset FGR fetuses (p: 0.012). Left MPI was 0.51 ± 0.09 in AGA and 0.62 ± 0.11 in the late‐onset FGR group. Left MPI was markedly higher in late‐onset FGR fetuses (p: 0.024). TAPSE was 7.4 ± 2.9 mm in controls and 5.2 ± 1.8 in the late‐onset FGR group, and it was significantly shorter in the late‐onset FGR fetuses (p: 0.016). Conclusion Late‐onset FGR is associated with cardiac remodeling and dysfunction. Fetal echocardiography may be beneficial to detect those subtle cardiac changes.