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The effect of fetal congenital heart disease on in utero urine production rate
Author(s) -
Xie JingXian,
Lv GuoRong,
Chen QiuYue,
Hou Min
Publication year - 2012
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.3852
Subject(s) - fetus , medicine , in utero , urine , gestational age , heart failure , heart disease , cardiology , fetal heart , fetal echocardiography , pregnancy , prenatal diagnosis , biology , genetics
Objectives To evaluate the influence of congenital heart disease (CHD) or congestive heart failure (CHF) on fetal urine production rate (UPR) and to establish normal reference intervals. Methods A cross‐sectional study was performed on normal fetuses ( n = 314) and on fetuses with CHD ( n = 49). CHD cases were divided into groups on the basis of heart function as defined by Huhta score: with CHF ( n = 11) and without CHF ( n = 38). Fetal bladder volume was measured by two‐dimensional as well as three‐dimensional ultrasound with the Virtual Organ Computer‐aided Analysis technique. Results In normal fetuses, UPR increased with gestational age from a mean value of 4.5 mL/h at 21 weeks to 66.5 mL/h at 40 weeks. There were no significant differences in UPR between CHD cases without CHF and controls ( P = 0.581). However, fetuses with CHF had decreased UPR values (Controls vs. CHF, P = 0.007) compared with the controls. The interobserver and intraobserver variability for assessment of UPR was better using three‐dimensional rather than two‐dimensional US. Conclusions Fetal UPR can be reproducibly measured by the Virtual Organ Computer‐aided Analysis technique. It appears that heart function, rather than CHD, affects fetal UPR. Fetal UPR may therefore be an additional indicator of CHF. © 2012 John Wiley & Sons, Ltd.