Maternal cardiac function in fetal growth-restricted and non-growth-restricted small-for-gestational age pregnancies.
OBJECTIVE
To compare maternal cardiac function in women with intrauterine growth restriction (IUGR) to those with small-for-gestational age (SGA) pregnancies (non-IUGR).


METHODS
This was a cross-sectional study involving maternal echocardiography and uterine, umbilical and fetal middle cerebral artery Doppler assessment in 52 normotensive women at 20-36 weeks' gestation with SGA fetuses (26 IUGR and 26 non-IUGR).


RESULTS
In the IUGR (compared to the non-IUGR) group, maternal cardiac output (CO) was lower (4.7 vs. 6.1 L/min, P<0.001) and total vascular resistance (TVR) was higher (1444 vs. 1088 dynes/s/cm5, P<0.001). The lower CO was due to a lower preload, demonstrated by a reduced stroke volume (59.9 vs. 73.6 mL, P<0.01) and smaller left atrial diameter (LAD) (31.5 vs. 34.1 mm, P=0.01). Mean arterial pressure and diastolic function were similar between the groups. Logistic regression and receiver-operating characteristics curve analysis for detection of IUGR demonstrated that a model using TVR, LAD, fetal middle cerebral artery pulsatility index and gestational age, had a sensitivity of 96.2% and a specificity of 84.6%.


CONCLUSIONS
Maternal echocardiography can provide a very sensitive tool for identifying IUGR pregnancies.
Bamfo
J E A K
JEAK
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, Denmark Hill, London, UK.
Kametas
N A
NA
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, Denmark Hill, London, UK.
Chambers
J B
JB
Cardiothoracic Centre, Guy's and St Thomas's Hospitals, Lambeth Palace Road, London, UK.
Nicolaides
K H
KH
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, Denmark Hill, London, UK.
D000328:Adult; D002303:Cardiac Output, Low / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000196:embryology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging*; D011256:Pregnancy Outcome; D012372:ROC Curve; D012044:Regression Analysis; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014655:Vascular Resistance