Abstract
Objective
To examine cardiac function in appropriately grown, small for gestational age and
intrauterine growth restricted fetuses and investigate the relationship between cardiac
function and fetal arterial and venous Doppler parameters.
Study design
Myocardial performance index, isovolumetric contraction time, isovolumetric relaxation
time, ejection time, and umbilical artery, middle cerebral artery and ductus venosus
Doppler pulsatility index were measured for women between 24 and 32 weeks with small
for gestational age and intrauterine growth restricted fetuses. Forty-eight appropriately
grown, 11 small for gestational age and 12 intrauterine growth restricted cases were
included. The relationship between cardiovascular parameters and gestation was defined
and Doppler values converted to Z-scores in relation to gestational age.
Results
In small for gestational age fetuses and fetuses with intrauterine growth restriction
the myocardial performance index was 0.66 (0.63–0.7) and 0.64 (0.60–0.67), respectively,
and compared to appropriately grown fetuses, at 0.45 (0.43–0.47), was significantly
increased (p = 0.001). No relationship was found between the myocardial performance index and arterial
and venous Doppler Z-score.
Conclusion
Small for gestational age and intrauterine growth restricted fetuses demonstrate altered
cardiac function in the late second and early third trimester of pregnancy. Importantly,
the myocardial performance index is raised in small for gestational age fetuses before
the arterial and venous Doppler abnormalities that characterize hypoxia are evident.
Keywords
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Article info
Publication history
Published online: October 07, 2013
Accepted:
September 19,
2013
Received in revised form:
September 9,
2013
Received:
June 23,
2013
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
