Aleida Susana Castellanos Gutierrez1,2,3, Ralf Schmitz4, Kerstin Hammer5, Janina Braun5, Kathrin Oelmeier5, Helen Ann Köster5, Mareike Möllers5, Walter Klockenbusch5, Johannes Steinhard6, Karol Kubiak7. 1. Department of Obstetrics and Gynecology, Christophorus-Kliniken GmbH, Coesfeld, Germany. susanacaste.md@gmail.com. 2. Department of Maternal-Fetal Medicine, Institute Clinic of Gynecology, Obstetrics and Neonatology (ICGON), Hospital Clinic-IDIBAPS, University of Barcelona and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain. susanacaste.md@gmail.com. 3. Department of Obstetrics and Gynecology, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany. susanacaste.md@gmail.com. 4. Department of Obstetrics and Gynecology, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany. schmitzr@ukmuenster.de. 5. Department of Obstetrics and Gynecology, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany. 6. Department of Fetal Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Georgstraße 11, 32545, Bad Oeynhausen, Germany. 7. Department of Obstetrics and Gynecology, St. Franziskus-Hospital Münster, Münster, Germany.
Abstract
OBJECTIVE: To compare the fetal brain structures assessed in routine sonographic scans during the second and third trimesters in fetuses with and without congenital heart disease (CHD). METHODS: This is a retrospective cross-sectional single-center study. We measured the head circumference (HC), the transversal diameter of the cerebellum (TCD) and the sizes of the cisterna magna (CM), the cavum septi pellucidi (CSP) and the posterior ventricles (PV) between 20 and 41 weeks of gestation. We compared 160 fetuses with CHD (case group) to 160 fetuses of normal pregnancies (control group). Every patient was matched with a control, considering the gestational age at which the ultrasound was performed. We divided the CHD group into 3 subgroups: retrograde flow in the aortic arch (group 1), right heart anomaly with the antegrade flow in the aortic arch (group 2) and other CHDs with the antegrade flow in the aortic arch (group 3). RESULTS: The mean width of the PV was larger in fetuses of groups 1 and 3 in comparison to the control group (P < 0.001, P = 0.022; respectively). We found that the APGAR score at 5 min (P < 0.001, P < 0.001; respectively) and gestational age at delivery (P = 0.006, P = 0.001; respectively) were inferior in groups 1 and 3 compared to controls. CONCLUSIONS: Central nervous system biometry is altered in fetuses with CHD. PV is enlarged in CHD fetuses especially with decreased oxygen levels in the aortic arch.
OBJECTIVE: To compare the fetal brain structures assessed in routine sonographic scans during the second and third trimesters in fetuses with and without congenital heart disease (CHD). METHODS: This is a retrospective cross-sectional single-center study. We measured the head circumference (HC), the transversal diameter of the cerebellum (TCD) and the sizes of the cisterna magna (CM), the cavum septi pellucidi (CSP) and the posterior ventricles (PV) between 20 and 41 weeks of gestation. We compared 160 fetuses with CHD (case group) to 160 fetuses of normal pregnancies (control group). Every patient was matched with a control, considering the gestational age at which the ultrasound was performed. We divided the CHD group into 3 subgroups: retrograde flow in the aortic arch (group 1), right heart anomaly with the antegrade flow in the aortic arch (group 2) and other CHDs with the antegrade flow in the aortic arch (group 3). RESULTS: The mean width of the PV was larger in fetuses of groups 1 and 3 in comparison to the control group (P < 0.001, P = 0.022; respectively). We found that the APGAR score at 5 min (P < 0.001, P < 0.001; respectively) and gestational age at delivery (P = 0.006, P = 0.001; respectively) were inferior in groups 1 and 3 compared to controls. CONCLUSIONS: Central nervous system biometry is altered in fetuses with CHD. PV is enlarged in CHD fetuses especially with decreased oxygen levels in the aortic arch.
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