Premium
Hemodynamic adaptation to suboptimal fetal growth in patients with single ventricle physiology
Author(s) -
Alsaied Tarek,
Tseng Stephanie,
King Eileen,
Hahn Eunice,
Divanovic Allison,
Habli Mounira,
Cnota James
Publication year - 2018
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14047
Subject(s) - hemodynamics , fetus , umbilical artery , medicine , ventricle , vascular resistance , gestational age , middle cerebral artery , cardiology , gestation , heart rate , pregnancy , blood pressure , biology , ischemia , genetics
Background In fetuses with structurally normal heart and suboptimal fetal growth ( SFG ), umbilical artery vascular resistance increases as measured by umbilical artery pulsatility index ( UA ‐ PI ). The objective of this study is to compare hemodynamic responses to SFG in fetuses with single ventricle ( SV ) and controls with structurally normal heart. Methods Fetal echocardiograms around 30 weeks of gestation were reviewed. UA ‐ PI and middle cerebral artery pulsatility index ( MCA ‐ PI ) were calculated. SFG was defined as a birth weight below 25th percentile for gestational age. Results Studies from 92 fetuses were reviewed— SV (n = 50) and controls (n = 42). The prevalence of SFG was higher in SV compared to controls (46% vs 21%, P = .02). In patients with normal heart and SFG , UAPI was significantly higher than normal controls ( P = .003) suggesting increased placental vascular resistance. In SV with SFG there was no difference in UAPI compared to SV without SFG . There was no difference in MCA ‐ PI between the groups. Conclusions The hemodynamic response to SFG in SV varies from fetuses with structurally normal heart. The mechanism of SFG and the placental pathology may be distinct in SV .