Clinical study of cerebrovascular blood flow dynamics in fetus with congenital heart disease

Abstract

Objective To determine whether CHD modify cerebrovascular flow dynamics in CHD fetuses,and the influence on different types of CHD.Methods Two hundred normal fefuses and 159 fetuses who were diagnosed CHD by prenatal echocardiogram were studied.CHD fetuses were divided into 6 groups according to hemodynamics:hypoplastic left heart syndrome(HLHS,n=23),left-sided obstructive lesions(LSOL,n=19),hypoplastic right heart syndrome(HRHS,n=15),right-sided obstructive lesions (RSOL,n=33),septal defect(SD,n=36),conotruneal defects(CTD,n=33).The pulsatility index(PI) and the cerebroplacental Doppler ratio(CPR)of the middle cerebral artery(MCA)and umbilical artery(UA) in normal and CHD group were measured by color Doppler flow system.Results MCA-PI and CPR in HLHS,HRHS,RSOL,CTD and SD groups all decreased compared with normal fetuses(P 0.05).Conclusions Fetuses with CHD had decreasing eerebrovascular impedance.Different types of CHD had different levels of eerebrovascular impedance,which indicated that different types of CHD induced different levels of cerebrovascular circulationcompensation. Key words: Ultrasonography,prenatal; Heart defects,congenital; Middle cerebral artery; Hemodynamic phenomena