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Changes in fetal circulation associated with congenital heart disease and their effects on fetal growth

Mina Itsukaichi1, Akira Kikuchi, Kosuke Yoshihara

  • 1Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Japan. mina-its@med.niigata-u.ac.jp

Fetal Diagnosis and Therapy
|August 19, 2011
PubMed

Insights

Fetuses with congenital heart disease (CHD) show restricted growth and altered blood flow, indicated by changes in the middle cerebral artery (MCA) and umbilical artery (UA) resistance index (RI). These findings highlight circulatory and growth challenges in fetuses with CHD.

Area of Science:

  • Perinatology
  • Fetal Cardiology
  • Developmental Biology

Background:

  • Congenital heart disease (CHD) affects fetal development and circulation.
  • Understanding fetal growth patterns and cerebrovascular resistance is crucial for managing CHD.

Purpose of the Study:

  • To investigate the association between fetal growth parameters and cerebrovascular resistance in fetuses diagnosed with congenital heart disease (CHD).

Main Methods:

  • Fetal echocardiography was utilized to assess biometric parameters (biparietal diameter, abdominal circumference, femur length, estimated fetal body weight) and cerebrovascular resistance (middle cerebral artery [MCA] resistance index [RI], umbilical artery [UA] RI).
  • A cohort of 44 fetuses with CHD and 140 normal fetuses between 28-34 weeks gestation were studied.

Main Results:

  • Fetuses with CHD demonstrated significantly reduced femur length, estimated fetal body weight, and birth measurements (body weight, length, chest circumference) compared to controls.
  • A higher prevalence of abnormal MCA RI (<10th percentile) and UA RI (>90th percentile) was observed in the CHD group.
  • No significant differences in biometric parameters were found between subgroups based on MCA RI values.

Conclusions:

  • Fetuses with CHD exhibit a higher incidence of growth restriction and altered fetal circulation compared to healthy fetuses.
  • Further research is warranted to elucidate the complex relationship between fetal growth and dynamic circulatory changes in the context of CHD.
Abstract

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