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Updated: Sep 11, 2025
Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
Published on: June 29, 2013
Assessment of fetal cardiac morphology and function in fetal growth restriction: insights from fetal heart
Lili Xiao1, Danyan Chen2, Liang Wang1
1Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou Key Laboratory of Structural and Functional Imaging, Wenzhou, China.
Background:
Research indicates that fetuses with fetal growth restriction (FGR) exhibit cardiac changes before abnormal Doppler blood flow is detected, but the predictive value of these cardiac parameters for diagnosing FGR remains uncertain. Fetal heart quantification (Fetal HQ), a novel technology for assessing fetal heart shape, size, and contractility, was evaluated in this study in terms of its effectiveness in detecting heart changes associated with FGR.
Methods:
From January 2023 to July 2023, 38 fetuses with FGR and 44 gestational-age-matched controls were selected at The Second Affiliated Hospital of Wenzhou Medical University. All participants underwent routine obstetric ultrasound, fetal echocardiography, and Fetal HQ. Cardiovascular parameters, the sphericity index (SI), and fractional shortening (FS) of 24 segments in both ventricles, along with their standard scores (Z-scores), were documented. The participants were followed up until birth, and then clinical data and cardiovascular measurements were collected and analyzed.
Results:
There were no significant differences in age, height, or body mass index (BMI) between the fetuses with FGR and the controls [age: 30.32±4.18 vs. 30.84±4.31 years, P=0.578; height: 158.39±4.68 vs. 160.34±5.25 cm, P=0.080; BMI: 26.67 (24.02, 27.60) vs. 26.43 (23.98, 28.60) kg/m2, P=0.937], Statistically significant differences were observed in left ventricular global longitudinal strain (LVGLS), right ventricular global longitudinal strain (RVGLS), four-chamber view (4CV) transverse width end diastole (4CVTWED), and the 4CV global spherical index (4CVGSI) between the groups (all P values <0.05). There were no significant differences between the two groups in terms of 4CV end-diastolic long diameter (4CVLED), 4CV area, left ventricular end-diastolic long diameter (LVLED), left ventricular end-systolic (LVES) area, left ventricular end-systolic long diameter (LVLES), right ventricular end-diastolic (RVED) area, right ventricular end-diastolic long diameter (RVLED), right ventricular end-systolic (RVES) area, and right ventricular end-systolic long diameter (RVLES), or the ratios of left ventricular end-diastolic (LVED) area to RVED area and LVLED to RVLED (all P>0.05). FS was significantly lower in the multiple left ventricular FS (LVFS)1-17 and right ventricular FS (RVFS)1-8 segments in the FGR group (all P<0.05). No significant differences were found in left ventricular SI (LVSI)1-24, right ventricular SI (RVSI)1-24, LVFS18-24, and RVFS9-24 between the groups (all P values >0.05). The FGR group, as compared to the control group, had significantly more cases with abnormal Z-scores (>2 or <-2: 84% vs. 52%, P=0.002) and with abnormal Z-scores in two or more parameters (50% vs. 12%, P<0.001). The interobserver intraclass correlation coefficient (ICC) for fetal parameters ranged from 0.72 to 0.80, and the intraobserver ICC ranged from 0.79 to 0.86.
Conclusions:
FGR fetuses exhibited notable cardiac abnormalities and impaired ventricular function. Fetal HQ technology can effectively evaluate these cardiac changes, offering crucial insights for clinical antenatal care.
