P213: Functional abnormalities in fetuses with IUGR and no structural malformations based on fetal echocardiography findings

Abstract

From the database of 5671 fetuses examined during 1992–2002, IUGR was diagnosed in 353 fetuses (6.2%). From this group there were 100 fetuses (1.8%) with normal heart anatomy and no extracardiac or chromosomal anomalies, which were qualified to the analysis. Neonatal follow up was available in 75 cases. Mean gestational age at the time of diagnosis was 34. Mean retardation growth was 4 weeks. In 55% functional abnormalities were found: cardiomegaly – 22x, myocardium hypertrophy – 20x, fetal heart disproportion (RV > LV) – 17x, tricuspid regurgitation – 17x, pericardial effusion – 5x, and in single cases there were: mitral and pulmonary regurgitation, FO abnormal flow, increased flows by aortic and pulmonary valves. In 10 cases arrhythmia were diagnosed. In 16 fetuses (16%) vascular centralization was present. From 75 fetuses, there were 69 survivors (92%), and 6 fetal or neonatal deaths (8%). All non-survivors presented heart functional abnormalities (5 with additional vascular centralisation). Mean gestational age at the time of delivery was 37; there were 44 cesarean sections (59%) and 31 vaginal deliveries (41%). Mean Agar score was 7 (0–10), mean birth weight was 2216 g (500–3300 g). Mean hospital stay in the group without functional abnormalities was 10 days, while in the group with functional abnormalities was 19 days (p < 0.05). In 7 cases (9.3%) heart defects were diagnosed after birth (ASD II, PDA, PS).