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Maternal cardiac function in fetal growth restriction.

J E A K Bamfo¹, N A Kametas, O Turan

¹Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, Denmark Hill, London, UK.

BJOG : an International Journal of Obstetrics and Gynaecology

|July 11, 2006

Summary

Severe fetal growth restriction (FGR) in normotensive women is linked to reduced maternal systolic function and increased total vascular resistance (TVR). This suggests TVR could aid in FGR management.

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Area of Science:

Obstetrics and Gynecology
Maternal-Fetal Medicine
Cardiovascular Physiology

Background:

Fetal growth restriction (FGR) impacts maternal health.
Assessing maternal cardiovascular changes in FGR is crucial for understanding pregnancy complications.

Purpose of the Study:

To evaluate maternal central hemodynamics in normotensive pregnancies affected by severe FGR.
To identify specific cardiovascular alterations associated with FGR.

Main Methods:

A cross-sectional study involving 107 women with normal pregnancies and 20 with severe FGR.
Utilized two-dimensional and M-mode echocardiography to assess maternal left ventricular systolic and diastolic function.
Measurements were taken in normotensive women between 25-37 weeks gestation.

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Main Results:

Women with FGR exhibited significantly increased total vascular resistance (TVR).
Reduced maternal systolic function was observed in the FGR group, indicated by lower cardiac output, stroke volume, and heart rate.
Mean arterial pressure (MAP) did not differ significantly between the FGR and normal pregnancy groups.

Conclusions:

Severe FGR is associated with impaired maternal systolic function and elevated TVR, despite normal MAP.
Total vascular resistance may serve as a valuable marker for classifying and managing FGR.
Findings suggest increased blood viscosity in FGR may result from inadequate intravascular space expansion.