The Relationship between Abnormal Echocardiography Findings in Fetus with Small Gestational Age

Abstract

Background: Intrauterine growth restriction (IUGR), refers to a condition in which the fetus does not grow well according to its genetic potential. Development of the cardiovascular system and impairing fetal developmental planning ultimately caused long-term cardiovascular morbidity. In the present study, the incidence of cardiac abnormalities in fetuses affected by IUGR as well as factors related to the occurrence of these abnormalities were evaluated.
 
 Material and Methods: In this descriptive-analytical study, pregnant women referred to the Imam Khomeini Hospital in Ahvaz during February 2018 to January 2020 were recruited. Complete clinical information was recorded using a questionnaire. The recorded information included age, birth weight, gestational age, weight and BMI and comorbidities. Then, echocardiographic data; structural abnormalities including septal condition, valves and outflow of large arteries, and the presence of mass or oxygen in the heart and pulmonary arteries, EF and HR, were extracted from the medical records.
 
 Results: In the present study, 152 patients were studied. The mean age of patients was 28.2 ranged from 17- to 40year. Fetal echocardiography showed that nearly 60% of fetuses had heart abnormalities. The most common disease was ventricular septal defect (VSD) (n = 21,13.8%), followed by atrial septal defec(ASD) (n = 15,9.9%) and concurrent ASD and VSD was observed in of 11.2% cases (n = 17). The incidence of echocardiographic abnormalities in IUGR fetuses was significantly higher than in SGA (p = 0.0001). However, the type of IUGR did not have a significant relationship with the incidence of echocardiographic findings in terms of time of performance (Early or late). Among the Doppler ultrasound factors, uterine artery PI (p = 0.001) and umbilical artery PI (p = 0.008) were associated with fetal heart abnormalities.
 
 Conclusion: In general, the findings of this study showed that the incidence of heart disorders in IUGR fetuses is high and is related to the severity of fetal growth restriction. Cardiac abnormalities are more common in IUGR fetuses than in SGA. Our results have also shown that the umbilical artery PI and uterine artery PI can be used as predictive factors in diagnosing fetal heart abnormalities. Our findings suggest an evaluation of echocardiography in IUGR fetuses.