Abstract
Data suggest fetuses with congenital heart disease (CHD) have placental abnormalities. Their abnormal placental vasculature may affect fetal placental blood flow, which has not previously been explored. We performed a retrospective cross-sectional study comparing umbilical venous volume flow (UVVF) of single ventricle, D-transposition of the great arteries, and tetralogy of Fallot fetuses with fetuses without CHD. UVVF and combined cardiac output (CCO) were calculated from fetal echocardiography and compared using t-tests, Chi-square and Fisher's exact tests. Mean gestational age and fetal weight were greater in CHD fetuses (26.5 weeks, 1119.4g; n=81, p<0.001) compared to controls (23.1 weeks, 675g; n=170, p<0.001). UVVF/fetal weight was nevertheless decreased among cases (99.8 versus 115.3 mL/min/kg, p<0.001). Subgroup analysis of 20- to 25-week fetuses demonstrated no significant differences in case and control baseline characteristics. In CHD fetuses (n=31) compared to controls (n=144), absolute UVVF (50.8 versus 62.1 mL/min, p=0.006), and UVVF/fetal weight (98.8 versus 118.5 mL/min/kg, p<0.001) were decreased. Findings were similar in single ventricle (n=24) and hypoplastic left heart syndrome (n=14). Mid-gestational placen...Continue Reading
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