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Fetal cardiac disease and fetal lung volume: an in utero MRI investigation
Author(s) -
Mlczoch Elisabeth,
Schmidt Lisa,
Schmid Maximilian,
Kasprian Gregor,
Frantal Sophie,
BergerKulemann Vanessa,
Prayer Daniela,
MichelBehnke Ina,
SalzerMuhar Ulrike
Publication year - 2014
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.4308
Subject(s) - fetus , medicine , lung , fetal echocardiography , in utero , gestational age , heart disease , cardiology , lung volumes , magnetic resonance imaging , pregnancy , gestation , cardiac function curve , prenatal diagnosis , obstetrics , radiology , heart failure , genetics , biology
Objectives 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. Conclusion 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. © 2013 John Wiley & Sons, Ltd.