Intermediate Diastolic Velocity as a Parameter of Cardiac Dysfunction in Growth-Restricted Fetuses.
OBJECTIVE
To evaluate the intermediate intracardiac diastolic velocities in fetuses with growth restriction.


METHODS
Doppler waveforms of the two atrioventricular valves were obtained. Peak velocities of the E (early) and A (atrial) components, and the lowest intermediate velocity (IDV) between them, were measured in 400 normally grown and in 100 growth-restricted fetuses. The prevalence of abnormal IDV, E/IDV, and A/IDV ratios in fetuses presenting with perinatal death or acidemia at birth (pH ≤7.1) was estimated.


RESULTS
IDV was significantly lower and E/IDV ratios significantly higher in the two ventricles of growth-restricted fetuses with reduced diastolic velocities in the umbilical artery (p < 0.05). In 13 fetuses presenting with perinatal death or acidemia at birth, 11 (85%) had either an E/IDV or A/IDV ratio >95th percentile, whereas 5 (38%) showed absent or reversed atrial velocities in the ductus venosus (DV-ARAV; p < 0.04). Fetuses without DV-ARAV but with elevated E/IDV ratios in either ventricle were nearly 7-fold more likely to have perinatal demise or acidemia at birth (OR 6.9, 95% CI 1.4-34) than those with E/IDV ratios <95th percentile.


CONCLUSIONS
The E/IDV and A/IDV ratios in the two cardiac ventricles might provide information about the risk of perinatal demise or acidemia in growth-restricted fetuses.
Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Md. and Detroit, Mich., USA.
Xiangna
X
Tang
Edgar
E
Hernandez-Andrade
Hyunyoung
H
Ahn
Maynor
M
Garcia
Homam
H
Saker
Steven J
SJ
Korzeniewski
Adi L
AL
Tarca
Lami
L
Yeo
Sonia S
SS
Hassan
Roberto
R
Romero
D000293:Adolescent; D000328:Adult; D003971:Diastole; D005260:Female; D005317:Fetal Growth Retardation / Q000503:physiopathology*; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D008137:Longitudinal Studies; D011247:Pregnancy; D055815:Young Adult