Abstract
To observe Doppler changes in the three main cerebral arteries in fetuses with congenital heart defects (CHDs). The pulsatility index (PI) values of the anterior cerebral artery (ACA), middle cerebral artery (MCA), and posterior cerebral artery (PCA) were prospectively compared in 78 CHD fetuses and 78 normal control fetuses. Correlations between the cerebral artery PIs and the neurodevelopment scores (psychomotor development index [PDI] and mental development index [MDI]) were assessed. The MCA-PI was decreased significantly in fetuses with hypoplastic left heart syndrome (HLHS). The ACA-PI was reduced significantly in fetuses with HLHS, fetuses with left-sided obstructive lesions (LSOLs) and fetuses with transposition of the great arteries. The PCA-PI was significantly smaller in fetuses with HLHS and fetuses with LSOLs. More fetuses presented signs of cerebral vasodilatation of the ACA than the MCA for certain types of CHD (P < 0.05). The ACA-PI was positively correlated with the PDI and MDI scores in fetuses with CHDs (r2 = 0.26, 0.20, P < 0.01). The MCA-PI was only positively correlated with the PDI scores (r2 = 0.15, P < 0.01). The ACA exhibited signs of vasodilatation more frequently and severely than the MCA. The ACA-PI appears to be more sensitive for predicting abnormal neurodevelopmental outcomes than the MCA-PI.
Highlights
Emerging studies have demonstrated that fetuses with congenital heart defects (CHDs) are at an increased risk of brain abnormalities and/or neurodevelopmental (ND) delays in the absence of known major aneuploidy or genetic disorders
At the end of pregnancies, 6 CHD fetuses were small for gestational age at birth or late-onset intrauterine growth restricted, including three with hypoplastic left heart syndrome (HLHS), one with left-sided obstructive lesions (LSOLs) and two with RSOLs
Our study showed that the middle cerebral artery (MCA)-pulsatility index (PI) was decreased only in fetuses with HLHS, while the anterior cerebral artery (ACA)-PI was reduced in fetuses with HLHS, LSOLs or TGA, and the posterior cerebral artery (PCA)-PI was reduced in fetuses with HLHS or LSOLs, indicating the presence of regional variations of brain perfusion in fetuses with CHDs
Summary
Emerging studies have demonstrated that fetuses with congenital heart defects (CHDs) are at an increased risk of brain abnormalities and/or neurodevelopmental (ND) delays in the absence of known major aneuploidy or genetic disorders. Our previous studies and others have shown changes in the fetal cerebral circulation in fetuses with CHDs. Our previous studies and others have shown changes in the fetal cerebral circulation in fetuses with CHDs Such changes include a lower middle cerebral artery pulsatility index (MCI-PI)[1,2,3,4,5,6,7,8], a lower cerebral placental ratio (CPR = MCA-PI/UA-PI), where UA represents the umbilical artery[1,2,3,7,8], and increased cerebral perfusion[1,5]. Several studies have demonstrated the existence of regional brain redistribution processes Both the anterior cerebral artery (ACA)[9,10] and the posterior cerebral artery (PCA)[11] present earlier signs of vasodilatation than the MCA in fetuses with intrauterine growth restriction (IUGR). Aorta hypoplasia/coarctation Aortic stenosis Interrupted aortic arch RSOLs TOF pulmonary stenosis PA-IVS Ebstein’s anomaly Tricuspid atresia TGA
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
