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Somatic growth trajectory in the fetus with hypoplastic left heart syndrome

James F Cnota1, Patrick T Hangge, Yu Wang

  • 1Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. james.cnota@cchmc.org

Pediatric Research
|June 18, 2013
PubMed

Insights

Fetal growth trajectory declines in late gestation for fetuses with hypoplastic left heart syndrome (HLHS). This suggests in utero growth abnormalities are present in HLHS pregnancies.

Area of Science:

  • Cardiology
  • Fetal Medicine
  • Neonatology

Background:

  • Fetal growth abnormalities in hypoplastic left heart syndrome (HLHS) are typically assessed by birth measurements.
  • Fetal growth trajectory in HLHS has not been previously described.
  • This study investigated the fetal growth trajectory in HLHS during late gestation.

Purpose of the Study:

  • To describe the fetal growth trajectory in fetuses diagnosed with HLHS.
  • To determine if fetal growth velocity declines in late gestation in HLHS.
  • To compare fetal weight z-scores with birth weight z-scores in HLHS.

Main Methods:

  • Retrospective review of fetal ultrasound and birth anthropometric data for 33 infants with prenatal HLHS diagnosis.
  • Calculation and comparison of z-scores for estimated fetal weight (EFWz) and birth weight (BWTz).
  • Analysis of umbilical artery Doppler to assess placental function.

Main Results:

  • A significant decrease in z-score was observed between estimated fetal weight and birth weight (mean difference -0.82, P < 0.0001).
  • 64% of HLHS subjects showed a decrease in z-score greater than 0.5.
  • Umbilical artery Doppler did not indicate significant placental insufficiency.

Conclusions:

  • The majority of fetuses with HLHS exhibit reduced growth velocity in the third trimester.
  • Growth abnormalities in HLHS appear to manifest during fetal development.
  • Further research is needed to explore the link between these in utero growth patterns and clinical outcomes.
Abstract

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