Fetal cardiac disease and fetal lung volume: an in utero MRI investigation.
OBJECTIVE
Magnetic resonance imaging (MRI) is a powerful, noninvasive tool to study fetal lung volumes after 18 weeks of gestation in vivo. In neonates with congenital heart disease (CHD), proper lung function is essential for postnatal survival. Antenatal detection of abnormal pulmonary development may help to optimize prenatal and perinatal management of at-risk fetuses. We aimed to investigate lung volumes in fetuses with prenatally diagnosed heart disease.


METHODS
A cross-sectional, retrospective study of 105 consecutive singleton pregnancies with CHD and a control, non-CHD group (n = 115), that underwent fetal MRI was performed. The heart defects detected were divided into four groups. Lung volumes of fetuses with heart disease were compared with control, non-CHD fetuses. In addition, z-scores of lung volumes were calculated for the CHD group (normal range z-scores from -2-+2).


RESULTS
As a group, fetuses with CHD have significantly smaller lung volumes compared with control fetuses when corrected by gestational age (GA) (p = 0.049). Of the 105 CHD fetuses studied, 18 had lung volumes with a z-score < -2. Fetuses with different types of CHD showed similar lung volumes.


CONCLUSIONS
Our data indicate that postpartum pulmonary symptoms and outcome in neonates with congenital heart disease may be attributed to the cardiac disease itself and in part to smaller lung volumes.
Division of Pediatric Cardiology, Pediatric Heart Center Vienna, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Austria.
Elisabeth
E
Mlczoch
Lisa
L
Schmidt
Maximilian
M
Schmid
Gregor
G
Kasprian
Sophie
S
Frantal
Vanessa
V
Berger-Kulemann
Daniela
D
Prayer
Ina
I
Michel-Behnke
Ulrike
U
Salzer-Muhar
D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006801:Humans; D008168:Lung / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D009929:Organ Size; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011651:Pulmonary Artery / Q000473:pathology*; D012189:Retrospective Studies