title: Fetal cardiac ventricular volume, cardiac output, and ejection fraction determined with 4-dimensional ultrasound using spatiotemporal image correlation and virtual organ computer-aided analysis.
abstract: OBJECTIVE
  The objective of this study was to quantify fetal cardiovascular parameters using spatiotemporal image correlation (STIC) and virtual organ computer-aided analysis (VOCAL).
  
  
  METHODS
  A cross-sectional study was performed in normal pregnancies (19-42 weeks) to evaluate ventricular volume, stroke volume (SV), cardiac output (CO), and ejection fraction (EF). The CO was also expressed as a function of estimated fetal weight and biometric parameters.
  
  
  RESULTS
  The following results were found: (1) 184 STIC datasets; (2) with advancing gestation, ventricular volume, SV, CO, and adjusted CO increased, whereas EF decreased; (3) right ventricular (RV) volume was larger than the left ventricular (LV) volume in systole (0.50 vs 0.27 mL; P < .001) and diastole (1.20 vs 1.03 mL; P < .001); (4) there were no differences between the LV and RV in SV, CO, or adjusted CO; and (5) LV EF was greater than the RV EF (72.2 vs 62.4%; P < .001).
  
  
  CONCLUSIONS
  Normal fetal cardiovascular physiology is characterized by a larger RV volume and a greater LV EF, resulting in similar LV and RV SV and CO.
authors.affiliation: Perinatology Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, and Detroit, MI, USA.
authors.forename: Neil
authors.initials: N
authors.lastname: Hamill
authors.forename: Lami
authors.initials: L
authors.lastname: Yeo
authors.forename: Roberto
authors.initials: R
authors.lastname: Romero
authors.forename: Sonia S
authors.initials: SS
authors.lastname: Hassan
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Myers
authors.forename: Pooja
authors.initials: P
authors.lastname: Mittal
authors.forename: Juan Pedro
authors.initials: JP
authors.lastname: Kusanovic
authors.forename: Mamtha
authors.initials: M
authors.lastname: Balasubramaniam
authors.forename: Tinnakorn
authors.initials: T
authors.lastname: Chaiworapongsa
authors.forename: Edi
authors.initials: E
authors.lastname: Vaisbuch
authors.forename: Jimmy
authors.initials: J
authors.lastname: Espinoza
authors.forename: Francesca
authors.initials: F
authors.lastname: Gotsch
authors.forename: Luis F
authors.initials: LF
authors.lastname: Goncalves
authors.forename: Wesley
authors.initials: W
authors.lastname: Lee
mesh_terms: D002302:Cardiac Output / Q000502:physiology*; D019561:Echocardiography, Four-Dimensional / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging / Q000502:physiology; D005865:Gestational Age; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D009929:Organ Size / Q000502:physiology; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000502:physiology; D011263:Pregnancy Trimester, Third / Q000502:physiology; D016216:Ultrasonography, Prenatal / Q000379:methods; D016276:Ventricular Function / Q000502:physiology*