The fetal cardiovascular response to increased placental vascular impedance to flow determined with 4-dimensional ultrasound using spatiotemporal image correlation and virtual organ computer-aided analysis

Neil Hamill, Roberto Romero, Sonia Hassan, Wesley Lee, Stephen A. Myers, Pooja Mittal, Juan Pedro Kusanovic, Mamtha Balasubramaniam, Tinnakorn Chaiworapongsa, Edi Vaisbuch, Jimmy Espinoza, Francesca Gotsch, Luis F. Goncalves, Shali Mazaki-Tovi, Offer Erez, Edgar Hernandez-Andrade, Lami Yeo

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Objective: We sought to determine if increased placental vascular impedance to flow is associated with changes in fetal cardiac function using spatiotemporal image correlation and virtual organ computer-aided analysis. Study Design: A cross-sectional study was performed in fetuses with umbilical artery pulsatility index >95th percentile (abnormal [ABN]). Ventricular volume (end-systole, end-diastole), stroke volume, cardiac output (CO), adjusted CO, and ejection fraction were compared to those of 184 normal fetuses. Results: A total of 34 fetuses were evaluated at a median gestational age of 28.3 (range, 20.6-36.9) weeks. Mean ventricular volumes were lower for ABN than normal cases (end-systole, end-diastole) with a proportionally greater decrease for left ventricular volume (vs right). Mean left and right stroke volume, CO, and adjusted CO were lower for ABN (vs normal) cases. Right ventricular volume, stroke volume, CO, and adjusted CO exceeded the left in ABN fetuses. Mean ejection fraction was greater for ABN than normal cases. Median left ejection fraction was greater (vs right) in ABN fetuses. Conclusion: Increased placental vascular impedance to flow is associated with changes in fetal cardiac function.

Original languageEnglish
Pages (from-to)153.e1-153.e13
JournalAmerican Journal of Obstetrics and Gynecology
Volume208
Issue number2
DOIs
StatePublished - 1 Jan 2013
Externally publishedYes

Keywords

  • 3-dimensional
  • 4-dimensional
  • STIC
  • VOCAL
  • cardiac function
  • cardiac output
  • contour finder
  • ejection fraction
  • fetal echocardiography
  • fetus
  • intrauterine growth restriction
  • prenatal diagnosis
  • sonography
  • spatiotemporal image correlation
  • stroke volume
  • umbilical artery Doppler
  • ventricular volume
  • virtual organ computer-aided analysis

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