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Updated: Mar 9, 2026
Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
Published on: June 29, 2013
Fetal hemodynamics and adverse outcome in primary school-aged children with fetal growth restriction: a prospective
Noora Korkalainen1,2, Juha Räsänen1,2,3, Tuula Kaukola2,4
1Department of Obstetrics and Gynecology, Oulu University Hospital, Oulu, Finland.
Insights
Fetoplacental circulatory abnormalities in fetal growth restriction predict adverse outcomes in children, including developmental delays. Early detection of absent/reversed umbilical artery flow and ductus venosus abnormalities aids in predicting long-term risks.
Area of Science:
- Perinatal Medicine
- Fetal Cardiology
- Developmental Pediatrics
Background:
- Fetal growth restriction (FGR) is linked to significant short- and long-term health issues.
- Understanding the long-term impact of FGR on child development is crucial.
Purpose of the Study:
- To investigate the association between fetoplacental circulatory abnormalities and adverse outcomes in children with FGR at primary school age.
- To identify specific hemodynamic parameters that predict long-term morbidity in FGR.
Main Methods:
- Prenatal ultrasonographic assessment of fetoplacental hemodynamics in 72 fetuses with FGR.
- Long-term outcome assessment at a median age of 9 years, including mortality, morbidity, and developmental status.
- Statistical analysis to determine the impact of abnormal hemodynamics on adverse outcomes.
Main Results:
- Children with FGR and adverse outcomes were born earlier and had lower birthweights.
- Absent/retrograde diastolic flow in the umbilical artery, reversed A-wave in the ductus venosus, cardiomegaly, hydrops, and a low cardiovascular profile score were associated with adverse outcomes.
- These parameters, particularly increased systemic venous pulsatility and low cardiovascular profile score, showed high predictive power for adverse long-term outcomes.
Conclusions:
- Specific fetal circulatory abnormalities, including umbilical artery and ductus venosus flow patterns, cardiomegaly, hydrops, and low cardiovascular profile score, are significant predictors of adverse outcomes in FGR children.
- These prenatal findings are vital for predicting the long-term prognosis of children affected by fetal growth restriction.
Introduction:
Fetal growth restriction is associated with short-term and long-term mortality and morbidity. We hypothesized that adverse outcome in children with fetal growth restriction at primary school age is associated with fetoplacental circulatory abnormalities.
Material And Methods:
Comprehensive ultrasonographic assessment of fetoplacental hemodynamics was performed in 72 growth-restricted fetuses prenatally, and short-term outcome data were collected. At the median age of 9 years, mortality and morbidity were determined using medical charts and questionnaires. The impact of abnormal fetoplacental hemodynamics on mortality and morbidity with significant developmental disorders or delay were studied.
Results:
Fetal growth restriction children with adverse long-term outcome were delivered earlier and with lower birthweights than were those with non-compromised outcome. Seventy percent of the fetal growth restriction group showed non-compromised long-term outcomes and participated in mainstream education at the appropriate age level. Absent/retrograde diastolic flow in the umbilical artery (p < 0.001), negative A-wave in the ductus venosus (p = 0.006), cardiomegaly (p = 0.02), hydrops (p = 0.006) and cardiovascular profile score <6 (p = 0.002) were associated with increased risk of adverse outcome. After adjustment for gestational age, these parameters demonstrated hazard ratios of 5.0-16.5 for adverse long-term outcome; increased systemic venous pulsatility and low cardiovascular profile score had the highest predictive power.
Conclusions:
Absent or reversed end-diastolic flow in the umbilical artery, reversed A-wave in the ductus venosus, cardiomegaly, hydrops, and low cardiovascular profile score are associated with adverse outcomes at primary school age in fetal growth restriction children. These fetal parameters play a significant role in the prediction of long-term outcomes for fetal growth restriction children.
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