Cardiac function monitoring of fetuses with growth restriction.
OBJECTIVE
To describe the time sequence of changes in cardiac function in intrauterine growth restriction.


METHODS
This was a prospective longitudinal study on 22 singleton pregnancies with growth-restricted fetuses. Pulsatility indices of fetal arterial and venous Doppler waveforms, systolic peak velocity in the aorta and pulmonary artery, right and left ventricular shortening fraction and atrioventricular flow E/A ratio were assessed at each monitoring session. Logistic regression was used for modeling the probability of abnormality of a variable in relation to the time interval before delivery. Trends over time were analyzed by Mann-Withney U-test.


RESULTS
Umbilical artery pulsatility index was the first variable to become abnormal, followed by the middle cerebral artery, right diastolic indices (right E/A, ductus venosus), right systolic indices and, finally, both diastolic and systolic left cardiac indices.


CONCLUSIONS
We have found an earlier and more pronounced right than left and diastolic than systolic fetal cardiac function deterioration in growth restricted fetuses monitored longitudinally.
Figueras
Francesc
F
Obstetrics and Gynecology Department, Hospital Clinic, Institut Dexeus, Bonanova 67, 08017, Barcelona, Spain. frafig@iudexeus.uab.es
Puerto
Bienvenido
B
Martinez
Josep M
JM
Cararach
Vicenç
V
Vanrell
Juan A
JA
D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D002585:Cesarean Section; D003971:Diastole; D005260:Female; D005317:Fetal Growth Retardation / Q000503:physiopathology*; D005318:Fetal Heart / Q000503:physiopathology*; D005323:Fetal Monitoring; D005865:Gestational Age; D006801:Humans; D006863:Hydrogen-Ion Concentration; D016015:Logistic Models; D020768:Middle Cerebral Artery / Q000196:embryology / Q000503:physiopathology; D011225:Pre-Eclampsia / Q000150:complications; D011247:Pregnancy; D011673:Pulsatile Flow; D013599:Systole; D018608:Ultrasonography, Doppler; D014469:Umbilical Arteries / Q000503:physiopathology