Assessment by three-dimensional power Doppler ultrasound of cerebral blood flow perfusion in fetuses with congenital heart disease

Zeng, Shi; Zhou, Jiawei; Peng, Qinghai; Liu, Tian; Xu, Ganqiong; Zhao, Yili; Wang, T.; Zhou, Qing

doi:10.1002/uog.14798

Cited by 29 publications

(44 citation statements)

References 22 publications

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“…It was postulated that MCA-PI is associated with cerebral blood flow and brain development in the fetus. In fetuses with HLHS, unlike the findings from Yamamoto et al, 14,15 our study showed that there was no significant difference in MCA-PI, UA-PI, and CPR between HLHS and normal fetuses. [11][12][13] It is also felt that the reduction of MCA-PI normalized by UA-PI may serve as a marker of severity of cardiovascular diseases.…”

Section: Resultscontrasting

confidence: 98%

Cerebrovascular hemodynamics in fetuses with congenital heart disease

Man

Zhao

et al. 2017

Echocardiography

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Our study suggests MCA-PI is lower in aortic stenosis and high in pulmonary atresia but not significantly different in other LSOL, HLHS, RSOL, and HRHS. MCA-PI regulation in CHD is probably more associated with left and right outflow obstruction, location of the obstruction, and hemodynamics rather than "brain sparing effect" or preferential shunting of blood to the fetal brain, heart, and adrenals in the stressed fetus (eg, IUGR). CPR may not be a sensitive measure for the effect of CHDs and their severity on cerebral and placental circulation.

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Section: Resultscontrasting

confidence: 98%

Cerebrovascular hemodynamics in fetuses with congenital heart disease

Man

Zhao

et al. 2017

Echocardiography

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“…Data regarding MCA flow were available in 21 articles (1412 fetuses). Most studies ( n = 14) calculated z ‐scores or percentiles to correct for the effect of the gestational age, using various normal reference populations (Table b) . Seven studies reported absolute values at a specific gestational age .…”

Section: Resultsmentioning

confidence: 99%

“…In eight articles (331fetuses, Table ), postnatal ND outcome was assessed. The correlation with fetal data was studied in seven articles . One study was identified as a possible duplicate .…”

Section: Resultsmentioning

confidence: 99%

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Fetal brain imaging in isolated congenital heart defects – a systematic review and meta‐analysis

et al. 2016

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Congenital heart defects (CHDs) are associated with neurodevelopmental (ND) delay. This study aims to assess evidence for impaired prenatal brain development, in fetuses with CHD. A systematical search was performed, and 34 studies evaluating the fetal brain [magnetic resonance imaging (MRI) or ultrasound] in isolated CHD were included . Data regarding cerebral abnormalities, head circumference growth and middle cerebral artery flow were extracted. Prenatal MRI was studied in ten articles (445 fetuses), resulting in a pooled prevalence of 18% (95%CI À6%; 42%) for combined structural and acquired cerebral abnormalities. Prenatal head circumference was studied in 13 articles (753 fetuses), resulting in a pooled z-score of À0.51 (95%CI À0.84; À0.18). Doppler was studied in 21 articles (1412 fetuses), resulting in a lower middle cerebral artery pulsatility index (z-score À0.70 95%CI À0.99; À0.41) in left-sided CHD only. We conclude that prenatal MRI and ultrasound demonstrate brain abnormalities, delay in head growth and brainsparing in subgroups of CHD. However, large MRI studies are scarce, and ultrasound data are biased towards severe and left-sided CHD. Long-term follow-up studies correlating prenatal findings with postnatal ND outcome are limited, and data are lacking to support counseling families regarding ND outcome based on prenatal findings suggestive of altered brain development.

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“…94 It consists of 5 parameters: signs of hydrops, F I G U R E 1 0 T 2 -weighted fetal magnetic resonance image of the chest of a fetus with hypoplastic left heart syndrome and intact atrial septum. 99 The prenatal diagnosis of CHD has shown important benefits to care including earlier age at treatment, decreased perioperative morbidity, and improved neurologic outcome in specific CHD. H = heart; RL = right lung; and LL = left lung.…”

Section: Cardiac Function Assessmentmentioning

confidence: 99%

Fetal echocardiography for planning perinatal and delivery room care of neonates with congenital heart disease

et al. 2017

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Fetal echocardiography facilitates the prenatal diagnosis of infants with congenital heart disease (CHD) and through sequential examinations, allows assessment of fetal hemodynamics and cardiovascular status from the time of diagnosis to delivery. Fetal cardiologists have created diagnostic protocols aimed at risk stratifying severity and potential postnatal compromise in fetuses with CHD, and identifying those who may require special intervention at birth or within the first days of life. In this article, we review fetal cardiovascular physiology, the progression of CHD in utero and fetal echocardiographic findings used for risk stratification of newborns with CHD, as well as some of the basic principles of planning for the neonatal resuscitation and initial transitional care of these complex newborns.

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Assessment by three-dimensional power Doppler ultrasound of cerebral blood flow perfusion in fetuses with congenital heart disease

Cited by 29 publications

References 22 publications

Cerebrovascular hemodynamics in fetuses with congenital heart disease

Cerebrovascular hemodynamics in fetuses with congenital heart disease

Fetal brain imaging in isolated congenital heart defects – a systematic review and meta‐analysis

Fetal echocardiography for planning perinatal and delivery room care of neonates with congenital heart disease

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