Dynamics of the septum primum in fetuses with intrauterine growth restriction.
OBJECTIVE
To test the hypothesis that the linear displacement of the septum primum (SP) is lower in fetuses with intrauterine growth restriction (IUGR) than in fetuses with appropriate growth for gestational age (AGA).


METHODS
In a cross-sectional study, the ratio between the SP displacement and left atrial diameter (excursion index [EI]) was compared in 27 fetuses with IUGR (group 1), 24 fetuses with AGA of hypertensive mothers (group 2), and 35 controls (group 3). Flow through the atrioventricular (AV) valves and the umbilical artery resistance index (RI) were also compared.


RESULTS
Irrespective of gestational age, mean EI in group 1 (0.41 +/- 0.07) was significantly lower than in group 2 (0.48 +/- 0.07; p < 0.001) and than in group 3 (0.50 +/- 0.06; p < 0.001), with no significant differences between groups 2 and 3. In fetuses over 30 weeks of gestation of group 1, EI was lower (0.38 +/- 0.05) than in group 2 (0.49 +/- 0.07) and group 3 (0.51 +/- 0.06; p < 0.001). There was significant inverse correlation between EI and RI (r = 0.46; p < 0.01) and no correlation between EI and AV flow velocities.


CONCLUSIONS
SP mobility is reduced in fetuses over 30 weeks with IUGR compared with AGA fetuses. These findings may depend on alterations of left ventricular diastolic function and are correlated to the degree of placental insufficiency.
Fetal Cardiology Unit, Institute of Cardiology of Rio Grande do Sul, FUC, Porto Alegre, Brazil.
Paulo
P
Zielinsky
Paulo Afonso
PA
Beltrame
João Luiz
JL
Manica
Antonio L
AL
Piccoli
Márcia Abdalla Teixeira
MA
da Costa
Lucília
L
Motta
Rômulo
R
Castagna
Luiz Henrique
LH
Nicoloso
D000704:Analysis of Variance; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003971:Diastole; D005260:Female; D047109:Fetal Development; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005865:Gestational Age; D006325:Heart Atria / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension; D010927:Placental Insufficiency; D011247:Pregnancy; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal; D014655:Vascular Resistance; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*