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Ductus arteriosus diameters in fetuses with early- and late-onset fetal growth restriction
Tülay Demircan1, Bahar Konuralp Atakul2, Barış Güven3
1School of Medicine, Department of Pediatric Cardiology, Dokuz Eylul University, Izmir, Turkey.
Insights
Fetal growth restriction (FGR) impacts fetal heart function. While ductus arteriosus diameter didn't significantly differ, ratios indicated changes in early-onset FGR, with higher cardiac function indicators observed in affected fetuses.
Area of Science:
- Perinatal cardiology
- Fetal medicine
- Neonatology
Background:
- Fetal growth restriction (FGR) is a significant complication affecting perinatal outcomes.
- Abnormalities in fetal heart function and ductus arteriosus (DA) are concerns in FGR pregnancies.
- Evaluating intrauterine cardiac function is crucial for understanding FGR-related risks.
Purpose of the Study:
- To assess intrauterine heart function and ductus arteriosus diameter in fetuses with FGR.
- To compare cardiac measurements between fetuses with FGR and normal controls.
- To investigate potential differences in cardiac function between early- and late-onset FGR.
Main Methods:
- Compared 37 fetuses with FGR to 37 controls matched for gestational age.
- Examined ventricular diameters, aorta, pulmonary artery, DA, and aortic arch.
- Calculated ratios of aortic annulus/ductus diameter and aortic isthmus/ductus diameter, and assessed myocardial performance index (MPI).
Main Results:
- No significant difference in ductus arteriosus (DA) diameters between FGR and control groups.
- Ratios of aortic annulus diameter/DA diameter and aortic isthmus diameter/DA diameter were lower in early-onset FGR.
- The modified myocardial performance index (mod-MPI) was elevated in the FGR group, indicating altered cardiac function.
Conclusions:
- Ductal diameters were not significantly different in FGR, but relative diameters indicated changes, particularly in early-onset cases.
- Elevated mod-MPI in fetuses with FGR suggests impaired cardiac function.
- These findings may aid in evaluating postnatal cardiac status in infants with FGR.
Purpose:
Fetal growth restriction (FGR) is a common pregnancy complication that can be associated with several adverse perinatal outcomes. One of these negative outcomes is ductus arteriosus, especially in preterm babies. In this study, intrauterine heart function and ductus diameter were evaluated in babies with FGR.
Methods:
Thirty-seven fetuses with FGR were compared with 37 normal-weight fetuses at the same gestational week. In our study, ventricular diameters, aorta, pulmonary artery, ductus arteriosus (DA), aortic arch diameter, and flow traces were examined. In addition, the aorta and aortic isthmus diameters were proportioned to the ductus diameter, and the left ventricular myocardial performance index (MPI) [(ICT + IRT)/ET] was evaluated.
Results:
There was no difference in DA diameters between the patient and control groups. The intragroup comparison of the cases with early- and late-onset FGR revealed no statistically significant difference between DA diameters. However, the ratios of the aortic annulus diameter/ductus diameter (AOD/DAD) and aortic isthmus diameter/ductus diameter (AID/DAD) were significantly lower in early-onset FGR because the diameter of the DA was greater. In addition, the mod-MPI values were higher in the patient group.
Conclusions:
In our study, although the ductal diameters did not change significantly in the patient group, the ductal diameter was greater in the early-onset intrauterine growth restriction (FGR) group compared with other cardiac measurements. The mod-MPI value, a cardiac function indicator, was higher in fetuses with FGR. These findings may be useful for evaluating postnatal cardiac functions in FGR.
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