Comparison of cardiac morphology and function in small for gestational age fetuses and fetuses with late-onset fetal growth retardation

Objectives To compare cardiac structural and functional findings of fetuses with fetal growth restriction (FGR) and small for gestational age (SGA). Methods In this prospective cohort study, patients were classified into three groups using Delphi procedure according to fetal weight, umbilical, uterine artery Doppler and cerebroplacental ratio. Fetal cardiac ultrasonographic morphology and Doppler examination was performed to all pregnant women at 36 weeks of gestation. Results Seventy three patients were included in the study. There were one (6.7%) patient in the control group, 2 (13.3%) in the SGA group and 12 (80%) in the FGR group who needed neonatal intensive care unit (NICU) and NICU requirement was significantly higher in FGR fetuses (p<0.001). Left spherical index was found to be lower only among FGR fetuses (p=0.046). Left ventricular wall thickness was decreased and the right/left ventricular wall ratio was increased in FGR fetuses (p=0.006, p<0.001). Tricuspid/mitral valve ratio and mitral annular plane systolic excursion value was lower in FGR fetuses (p=0.034, p=0.024 respectively). Also, myocardial performance index was remarkably higher in FGR group (p=0.002). Conclusions We detected cardiac morphological changes in cases of both SGA and FGR-more pronounced in the FGR cases. Findings related to morphological changes on the left side in FGR cases were considered secondary to volume increase in FGR cases as an indicator of a brain-protective effect. In the FGR group, both systolic and diastolic dysfunctions were detected in the left heart.

Automated summary

The study found that a higher percentage of FGR fetuses required neonatal intensive care unit compared to SGA fetuses. FGR fetuses demonstrated lower left spherical index, decreased left ventricular wall thickness, increased right/left ventricular wall ratio, lower tricuspid/mitral valve ratio, lower mitral annular plane systolic excursion value, and higher myocardial performance index. These findings suggest cardiac structural and functional changes in FGR cases, with both systolic and diastolic dysfunctions detected in the left heart.