Cardiac Measurements of Size and Shape in Fetuses With Absent or Reversed End-Diastolic Velocity of the Umbilical Artery and Perinatal Survival and Severe Growth Restriction Before 34 Weeks' Gestation

J Ultrasound Med. 2021 Aug;40(8):1543-1554. doi: 10.1002/jum.15532. Epub 2020 Oct 30.

Abstract

Objectives: The purpose of this study was to evaluate the end-diastolic size and shape of the 4-chamber view as well as the right ventricle (RV) and left ventricle (LV) in growth-restricted fetuses before 34 weeks' gestation with absent or reversed end-diastolic velocity of the umbilical artery and compare the results between those with perinatal deaths and those who survived the neonatal period.

Methods: Forty-nine fetuses with growth restriction and absent or reversed end-diastolic velocity of the umbilical artery were studied. The size, shape, and sphericity index of the 4-chamber view, RV, and LV were assessed. The number and percentage of fetuses with z score values of less than -1.65 and greater than 1.65 were computed.

Results: Of the 49 fetuses, there were 13 perinatal deaths (27%) and 36 (63%) neonatal survivors. Measurements that were unique for neonatal survivors were an increased RV apical transverse width and decreased measurements of the following: LV and RV widths, LV and RV areas, as well as RV sphericity indices.

Conclusions: Fetuses with a smaller RV and LV size and area and those with a globular-shaped RV were at significantly lower risk for perinatal death.

Keywords: absent umbilical artery diastolic flow; cardiomegaly; fetal death; fetal echocardiography; fetal growth restriction; global sphericity index; perinatal death; speckle tracking.

MeSH terms

  • Blood Flow Velocity
  • Female
  • Fetal Growth Retardation / diagnostic imaging
  • Fetus
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Pregnancy
  • Ultrasonography, Prenatal*
  • Umbilical Arteries* / diagnostic imaging