AI Article Synopsis
- The study explored how fetal head and overall body growth differ among babies with congenital heart defects (CHD) compared to healthy controls, using a large sample size of ultrasound exams.
- Specific types of CHD were analyzed, with the smallest head size observed in d-transposition of great arteries and noticeable growth issues in other groups, particularly around 28 weeks of gestation.
- Findings suggest that certain CHDs can lead to delayed head growth and indicate that monitoring hemodynamics may help identify neurodevelopmental risks and inform prenatal care.
Article 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. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:96-104, 2017.
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| http://dx.doi.org/10.1002/jcu.22395 | DOI Listing |
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