Head growth in fetuses with isolated congenital heart defects: lack of influence of aortic arch flow and ascending aorta oxygen saturation

Jansen, Frederik W.; Zwet, Erik W. van; Rijlaarsdam, María; Pajkrt, Eva; Velzen, C. L. van; Zuurveen, Hannah; Kragt, A.; Bax, C.; Clur, S. A.; Lith, J. M. M. van; Blom, Nico A.; Haak, Monique C.

doi:10.1002/uog.15980

Cited by 25 publications

(49 citation statements)

References 39 publications

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“…To put our results in perspective further, in our previous retrospective study regarding head circumference in CHD, we also found that especially fetuses with TOF appear to have a small head circumference at midgestation [21]. This finding has also been reported in an MRI study in TOF fetuses [22].…”

Section: Discussionsupporting

confidence: 54%

“…Our study included only 6 cases of HLHS with repeated measurements, because termination of the pregnancy was frequently chosen in cases with HLHS. In a retrospective cohort with 26 ongoing HLHS cases, we, however, did not find a deflecting head growth in this group [21]. When clustering our results on cerebral oxygenation or flow, no significant differences were identified either.…”

Section: Discussionmentioning

confidence: 69%

“…For the statistical analysis, CHD were clustered based on two aspects: oxygen delivery and flow to the brain. This method was previously described by our group [21]. For instance, the group with low or reduced oxygen delivery to the brain included transposition of the great arteries (TGA) (low oxygen) and univentricular CHD (mixed oxygen), and the normal oxygen group included pulmonary or aortic stenosis and persistent left caval vein with small LV (PLVCS).…”

Section: Methodsmentioning

confidence: 99%

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Fetuses with Isolated Congenital Heart Defects Show Normal Cerebral and Extracerebral Fluid Volume Growth: A 3D Sonographic Study in the Second and Third Trimester

et al. 2019

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Objective: The aim of our study is to explore whether the cerebral growth is delayed in fetuses with congenital heart defects (CHD) in the second and early third trimester. Methods: A prospective cohort study was conducted in 77 CHD cases, with 75 healthy controls. 3D cerebral volume acquisition was performed sequentially. The volumes of the fetal hemicerebrum and extracerebral fluid were compared by linear regression analysis, and the Sylvian fissure was measured. Results: Between 19 and 32 weeks of gestation, 158 measurements in cases and 183 measurements in controls were performed (mean 2.2/subject). The volume growth of the hemicerebrum (R² = 0.95 vs. 0.95; p = 0.9) and the extracerebral fluid (R² = 0.84 vs. 0.82, p = 0.9) were similar. Fetuses with abnormal oxygen delivery to the brain have a slightly smaller brain at 20 weeks of gestation (p = 0.02), but this difference disappeared with advancing gestation. CHD cases demonstrated a slightly shallower Sylvian fissure (mean ratio 0.146 vs. 0.153; p = 0.004). Conclusions: Our study shows no differences in cerebral growth, studied in an unselected cohort, with successive cases of isolated CHD. Even in the severest CHD cases, cerebral size is similar in the early third trimester. The cause and meaning of a shallower Sylvian fissure is unclear; possibly, it is a marker for delayed cerebral maturation or it might be an expression of decreasing amount of extracerebral fluid.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 69%

Section: Methodsmentioning

confidence: 99%

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Fetuses with Isolated Congenital Heart Defects Show Normal Cerebral and Extracerebral Fluid Volume Growth: A 3D Sonographic Study in the Second and Third Trimester

et al. 2019

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“…Smaller HC measurements in the second half of pregnancy have been extensively reported in fetuses with isolated CHD . One of the possible proposed mechanisms is disturbance in brain perfusion, similar to the so‐called brain sparing effect in fetuses with placental insufficiency, with lower middle cerebral artery pulsatility index and a lower cerebral‐placental ratio (CPR) …”

Section: Discussionmentioning

confidence: 99%

“…A reduction in fetal brain volume has been reported in infants with different types of CHD . This is also reflected by smaller fetal and neonatal head circumferences (HCs) …”

Section: Introductionmentioning

confidence: 99%

Growth patterns in fetuses with isolated cardiac defects

et al. 2018

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Evaluation of Intracranial Structures of Fetuses With Congenital Heart Defects

Turgut

Özdemir

Turan

et al. 2022

J of Ultrasound Medicine

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Objectives-We classified congenital heart defects (CHDs) according to cerebral blood flow oxygenation and aimed to evaluate the effect on the size of brain structures in these fetuses.Methods-The study which was designed retrospectively, included 28 patients with fetal CHDs and 76 patients without fetal anomalies.Results-The width and length of the cavum septum pellucidum significantly increased in the CHD group (P = .002, P = .004). The biparietal diameter and z scores were significantly lower in the single ventricle (SV) (P = .006, P = .019), and the head circumference (HC) and z scores were significantly lower in the transposition of great arteries (TGA) (P = .013, P = .038). The transverse cerebellar diameter, the cerebellar HC and the cerebellar hemisphere area values were lower in the SV (P = .005, P = .017, P = .044).Conclusions-Brain structure changes are more pronounced in groups with low cerebral oxygenation, especially in the SV and the TGA.

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Head growth in fetuses with isolated congenital heart defects: lack of influence of aortic arch flow and ascending aorta oxygen saturation

Abstract: Objectives Congenital heart defects (CHDs) are reported to be associated with a smaller fetal head circumference (HC)

Cited by 25 publications

References 39 publications

Fetuses with Isolated Congenital Heart Defects Show Normal Cerebral and Extracerebral Fluid Volume Growth: A 3D Sonographic Study in the Second and Third Trimester

Fetuses with Isolated Congenital Heart Defects Show Normal Cerebral and Extracerebral Fluid Volume Growth: A 3D Sonographic Study in the Second and Third Trimester

Growth patterns in fetuses with isolated cardiac defects

Evaluation of Intracranial Structures of Fetuses With Congenital Heart Defects

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