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Fetal growth restriction (FGR) is associated with several changes at the level of the fetal heart involving preload, after load, ventricular compliance, and myocardial contractility. An increase in after load is seen at the right ventricle owing to increased placental impedance [1]. A decrease in after load is noted at the level of the left ventricle owing to decreased cerebral impedance associated with the brain sparing reflex [1]. Evidence of reduced myocardial contractility in the presence of severe FGR has also been reported. Ventricular ejection force, an index of ventricular systolic function that is independent of preload and after load, is decreased at the level of the right and the left ventricles in FGR [2].

Comparison of Fetal Main Pulmonary Artery Doppler Wave Forms between Normally Grown and Growth Restricted Fetuses: A Case-Control Study