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Correlation between fetoplacental Doppler indices and measurements of cardiac function in term fetuses
Author(s) -
Alsolai A. A.,
Bligh L. N.,
Greer R. M.,
Kumar S.
Publication year - 2019
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.19056
Subject(s) - medicine , cardiology , umbilical artery , fetus , cardiac function curve , gestation , pregnancy , heart failure , biology , genetics
ABSTRACT Objective Redistribution of cardiac output (CO) is responsible for the brain‐sparing effect seen during periods of fetal stress. Our aim was to investigate prospectively the correlation between fetoplacental Doppler indices and measurements of cardiac function in uncomplicated term singleton pregnancy. Methods This was a prospective observational study of normotensive women with appropriately grown, non‐anomalous singleton pregnancy. Participants underwent fortnightly ultrasound examinations from 36 weeks' gestation until delivery, and intrapartum and neonatal outcomes were recorded. The correlation between fetoplacental Doppler indices and various measurements of cardiac function was evaluated. Results The study cohort comprised 273 singleton pregnancies. The cerebroplacental ratio (CPR) was correlated positively with left ventricular CO (LVCO) ( P < 0.001, rho = 0.29), left‐to‐right ventricular CO ratio (LVCO/RVCO; P < 0.001, rho = 0.41), global left ventricular strain ( P < 0.01, rho = 0.17) and global right ventricular strain ( P < 0.001, rho = 0.22). The CPR was correlated inversely with the left ventricular myocardial performance index ( P < 0.01, rho = –0.18) and the RVCO ( P < 0.001, rho = –0.28). The LVCO and global left ventricular strain were correlated positively with umbilical venous flow ( P = 0.04, rho = 0.18 and P < 0.001, rho = 0.25, respectively). There was minimal or no correlation between either the mean uterine artery pulsatility index (PI) or umbilical artery PI with any cardiac indices. Conclusion The fetal CPR, middle cerebral artery PI and umbilical venous flow are correlated positively with LVCO, LVCO/RVCO and global left ventricular strain in low‐risk term pregnancies. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.