Do Maternal Heart Diseases Affect Fetal Cardiac Functions?

Area of Science:

• Cardiology
• Maternal-Fetal Medicine
• Echocardiography

Background:

• Maternal heart disease (MHD) poses risks to both mother and fetus.
• Understanding the impact of MHD on fetal cardiac development is crucial for improved perinatal care.

Purpose of the Study:

• To investigate the effects of maternal heart disease on fetal cardiac function.
• To assess specific echocardiographic parameters in fetuses of mothers with diagnosed heart conditions.

Main Methods:

• 100 pregnant women (≥34 weeks) were studied: 40 with MHD and 60 controls.
• Fetal cardiac function assessed using M-mode, color tissue Doppler imaging (c-TDI), and pulsed wave Doppler.
• Maternal cardiac diseases classified using the New York Heart Association (NYHA) system.

Main Results:

• Fetuses in the MHD group showed significantly higher tricuspid annular plane systolic excursion and myocardial performance index (MPI), with prolonged isovolumetric relaxation time.
• Higher MPI values were observed in fetuses of mothers with NYHA Class II compared to Class I.
• No significant changes in fetal tricuspid annular peak velocity by c-TDI; no differences between acquired and congenital heart diseases.
• NYHA Class II was associated with lower birth weight, lower APGAR scores, and increased NICU admissions.

Conclusions:

• Maternal heart disease leads to alterations in fetal cardiac systolic and diastolic function.
• Elevated fetal MPI may indicate impaired global myocardial function due to maternal cardiac pathology.
• Progressive cardiac pathologies in pregnancy can affect fetal cardiac function and are linked to adverse perinatal outcomes.