Perinatal changes in cardiac geometry and function in growth-restricted fetuses at term

Area of Science:

• Cardiology
• Perinatology
• Fetal Medicine

Background:

• Fetal growth restriction (FGR) is a significant complication of pregnancy.
• Cardiac function in FGR requires further investigation, especially around the time of birth.

Purpose of the Study:

• To evaluate the impact of FGR at term on fetal and neonatal cardiac geometry and function.
• To compare cardiac parameters between normally grown and FGR fetuses and neonates.

Main Methods:

• Prospective study of 87 term pregnancies (54 normal, 33 FGR).
• Utilized fetal and neonatal echocardiography, including tissue Doppler and speckle tracking.
• Assessed cardiac geometry, myocardial deformation, and systolic/diastolic function before and after birth.

Main Results:

• FGR fetuses showed poorer myocardial deformation and cardiac function compared to controls.
• FGR neonates exhibited persistent alterations in cardiac parameters post-birth.
• Birth led to partial improvement in some cardiac indices for FGR neonates.

Conclusions:

• FGR fetuses and neonates display altered cardiac indices, indicating myocardial impairment.
• These alterations likely represent adaptations to placental hypoxemia and altered hemodynamics.
• Understanding these adaptations can improve FGR management and therapeutic strategies.