Functional Assessment of Fetal Heart in High Risk Pregnancies and Its Role In Prediction of Intrauterine Growth Restriction

Abstract

ABSTRACT newlineOur aim is to study the cardiac indices in normal and high risk fetuses and to identify the reliable indices for prediction of fetal growth restriction. 247 fetuses with and without associated risk factors for IUGR , more than 28 weeks of gestation , referred to radiology department for routine ultrasonography for the assessment of fetal well being, liquor volume, placental site localization, biophysical profile and fetal weight estimation were included in the study. Interval growth of the fetuses and liquor volume were assessed. Fetal cardiac function was assessed using the Myocardial Performance index, E/A ratio, Aortic Isthmic flow ratio and isthmic pulsatality index. we found a positive correlation between the gestational age and MPI of left side of heart and Early to Atrial phase diastolic ratio (E/A) at mitral and tricuspid valves ; a positive correlation between the myocardial performance index of right and left sides of fetal heart and an inverse relationship between the Ejection time of right and left sides and the MPI of respective sides. We also did not find a positive correlation between the ejection time and the aortic isthmic flow. The aortic isthmic PI was found to increase with gestational age, while IFI decreased with gestational age. Myocardial Performance Index of left side of heart and the Isthmic Flow Index / Aortic isthmic pulsatality index can be used as predictors of fetal growth restriction in high risk pregnancies newline