Sifa Turan1, Joshua I Rosenbloom1, Mostafa Hussein1, Christoph Berg2, Ulrich Gembruch2, Ahmet A Baschat3, Ozhan M Turan1. 1. Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine, 6th Floor, Room 6NE11, 22 South Greene Street, Baltimore, MD, 21201. 2. Department of Obstetrics and Prenatal Medicine, Friedrich Wilhelm University, Bonn, Germany. 3. Center for Fetal Therapy, Johns Hopkins University, Baltimore, MD.
Abstract
PURPOSE: Fetal head and somatic growth dynamics differs in fetuses with congenital heart defects (CHD). We longitudinally characterized fetal head and somatic growth in relation to the type of CHD. METHODS: Four hundred eleven exams from isolated CHD were compared with 1,219 controls. Head and somatic growth was assessed using head circumference (HC), brain volume (BrV = 1/6 × π × (HC/π)3)/2), fetal cephalization index (FCI = BrV/[estimated fetal weight]), and growth percentile. Umbilical and middle cerebral artery Doppler indices were obtained. CHD were grouped as: (1) d-transposition of great arteries (n = 11); (2) left ventricular outflow tract obstruction with retrograde isthmic flow (n = 18); (3) left ventricular outflow tract obstruction with antegrade isthmic flow (n = 16); (4) pulmonary outflow tract obstructions (n = 22). RESULTS: The smallest head size was seen in group 1. Growth asymmetry was diagnosed in group 2. Brain sparing was seen in groups 2 and 4 (p < 0.0001). HC and BrV percentiles decreased with advancing gestational age (p < 0.001) in group 2, and a significant drop was observed around 28 weeks. CONCLUSIONS: d-Transposition of great arteries and left-sided CHD leading to isthmic blood flow reversal are associated with delayed head growth. Prenatal evaluation of central hemodynamics in CHD may be contributive for predicting neurodevelopmental risks in CHD and help directing prenatal interventions.
PURPOSE: Fetal head and somatic growth dynamics differs in fetuses with congenital heart defects (CHD). We longitudinally characterized fetal head and somatic growth in relation to the type of CHD. METHODS: Four hundred eleven exams from isolated CHD were compared with 1,219 controls. Head and somatic growth was assessed using head circumference (HC), brain volume (BrV = 1/6 × π × (HC/π)3)/2), fetal cephalization index (FCI = BrV/[estimated fetal weight]), and growth percentile. Umbilical and middle cerebral artery Doppler indices were obtained. CHD were grouped as: (1) d-transposition of great arteries (n = 11); (2) left ventricular outflow tract obstruction with retrograde isthmic flow (n = 18); (3) left ventricular outflow tract obstruction with antegrade isthmic flow (n = 16); (4) pulmonary outflow tract obstructions (n = 22). RESULTS: The smallest head size was seen in group 1. Growth asymmetry was diagnosed in group 2. Brain sparing was seen in groups 2 and 4 (p < 0.0001). HC and BrV percentiles decreased with advancing gestational age (p < 0.001) in group 2, and a significant drop was observed around 28 weeks. CONCLUSIONS: d-Transposition of great arteries and left-sided CHD leading to isthmic blood flow reversal are associated with delayed head growth. Prenatal evaluation of central hemodynamics in CHD may be contributive for predicting neurodevelopmental risks in CHD and help directing prenatal interventions.
Authors: A E L van Nisselrooij; F A R Jansen; N van Geloven; I H Linskens; E Pajkrt; S-A Clur; L A Rammeloo; L Rozendaal; J M M van Lith; N A Blom; M C Haak Journal: Ultrasound Obstet Gynecol Date: 2019-12-27 Impact factor: 7.299
Authors: Shalin A Parekh; Stephany M Cox; A James Barkovich; Vann Chau; Martina A Steurer; Duan Xu; Steven P Miller; Patrick S McQuillen; Shabnam Peyvandi Journal: Pediatr Cardiol Date: 2021-12-01 Impact factor: 1.655