Pulmonary Vein PI, Cardiac Function and Remodeling in SGA Fetuses`.

Area of Science:

• Fetal Cardiology
• Perinatology
• Medical Imaging

Background:

• Fetal growth restriction (FGR) poses significant risks to fetal well-being.
• Cardiac function and remodeling are critical indicators of fetal health in FGR.
• Understanding cardiac changes in FGR is essential for timely intervention.

Purpose of the Study:

• To evaluate changes in myocardial performance index (MPI), global sphericity index (GSI), and pulmonary vein pulsatility index (PVPI) in fetuses with FGR.
• To assess the utility of these Doppler-derived indices as early predictors of fetal compromise in an Indian population.

Main Methods:

• A prospective observational study included 70 fetuses (26 weeks to term).
• Fetuses were categorized into controls (appropriate growth) and FGR (estimated fetal weight <10th percentile).
• PVPI, MPI, and GSI were measured using echocardiography and compared between groups.

Main Results:

• Fetuses with FGR showed a significantly decreased GSI (more globular heart) compared to controls (p=0.047).
• Increased PVPI was observed in FGR fetuses, indicating altered atrial dynamics (p=0.021).
• A shorter ejection time (ET), a component of MPI, was noted in FGR fetuses (p=0.047).

Conclusions:

• Fetal growth restriction is associated with cardiac remodeling, evidenced by a more globular heart shape (decreased GSI).
• Increased PVPI in FGR fetuses suggests changes in pulmonary vein flow and atrial function, potentially serving as an early marker of compromise.
• These Doppler parameters may offer valuable insights into fetal cardiac status in FGR before more established signs of distress appear.