Dynamics of pulmonary venous flow in fetuses with intrauterine growth restriction

Prenat Diagn. 2015 Mar;35(3):249-53. doi: 10.1002/pd.4529. Epub 2014 Dec 29.

Abstract

Objective: To test the hypothesis that the pulmonary vein pulsatility index (PVPI) is higher in fetuses with growth restriction (IUGR) than in normal fetuses.

Methods: Twenty-two fetuses with IUGR and twenty-one (21) fetuses with appropriate growth for gestational age from healthy mothers were studied. PVPI was calculated by Doppler echocardiography [maximal velocity (systolic or diastolic peak) - pre-systolic peak / mean velocity]. Obstetric ultrasound was used to assess fetal biometry and Doppler to assess the uterine, umbilical and middle cerebral arteries PI. Statistical analysis used t test and Pearson's correlation.

Results: Mean gestational age was 31.5 +/- 2.1 weeks in the control group and 31.4 +/- 3.1 weeks in IUGR (P = 0.91). The PI of uterine and umbilical arteries were higher in IUGR than in controls (P < 0.001). Mean PVPI in IUGR fetuses was 1.31 +/- 0.41, and in controls it was 0.83 +/- 0.11 (P < 0.001).

Conclusion: The pulsatility index of pulmonary venous flow in fetuses with growth restriction is higher than in normal fetuses, probably as a result of left atrial dynamics alteration secondary or not to fetal left ventricular diastolic dysfunction. © 2014 John Wiley & Sons, Ltd.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Case-Control Studies
  • Cross-Sectional Studies
  • Echocardiography, Doppler
  • Female
  • Fetal Growth Retardation / diagnostic imaging*
  • Fetal Growth Retardation / physiopathology
  • Fetal Heart / diagnostic imaging*
  • Fetal Heart / physiopathology
  • Hemodynamics
  • Humans
  • Middle Cerebral Artery / diagnostic imaging
  • Pregnancy
  • Prospective Studies
  • Pulmonary Circulation*
  • Pulmonary Veins / diagnostic imaging*
  • Pulmonary Veins / physiopathology
  • Pulsatile Flow*
  • Ultrasonography, Prenatal
  • Umbilical Arteries / diagnostic imaging
  • Uterine Artery / diagnostic imaging
  • Young Adult