Sustained maternal hyperoxygenation improves aortic arch dimensions in fetuses with coarctation.

Shi Zeng,Yili Zhao,Qinghai Peng,Wen Deng,Ming Zhang,Tao Wang,Jiawei Zhou,Qichang Zhou

doi:10.1038/srep39304

Abstract

The aim was to investigate the impact of maternal hyperoxygenation (HO) on cardiac dimensions in fetuses with isolated Coarctation (CoA). Fetal echocardiography was performed serially in 48 fetuses with CoA and gestation age matched normal fetues. The Z-scores for the mitral valve (MV), tricuspid valve (TV), aortic valve (AV), ascending aorta (AAo), isthmus, pulmonary valve (PV), main pulmonary artery (MPA), and descending aorta (DAo) were measured and compared among normal fetuses, CoA fetuses with oxygen and CoA fetuses with air. In the group with oxygen, 6 L/min oxygen was administered to the mother using a face mask. Regression analyses were performed to identify potential factors for HO outcome. The left heart dimension Z-scores increased gradually during HO therapy periods, especially at 4 weeks after oxygen therapy (P < 0.05). As for the case group with air, the left heart dimension remained unchanged. The duration of HO was associated with aortic arch Z-scores (adjusted R2 = 0.199, 0.60 for AAO and isthmus, respectively). Sustained maternal middle-flow oxygenation can be safely used to improve left heart dimensions in fetuses with isolated CoA. The duration of HO were associated with treatment outcome. These findings may provide useful information for developing novel treatment strategies.

Highlights

ResultsThe left heart dimension Z-scores in both cases groups were smaller than those in normal fetuses
In the group with oxygen, materno-fetal HO started at a gestational age of 30.44 ± 2.89 weeks and ended at a gestational age of 39.68 ± 0.78 weeks
This study revealed that sustained maternal oxygen therapy could improve left cardiac dimensions especially isthmus dimension in fetuses with coarctation

Summary

Results

The left heart dimension Z-scores in both cases groups were smaller than those in normal fetuses. As for the case group with air, the left heart dimension Z-scores remained unchanged (P > 0.05) and were smaller than those in control group (P < 0.01) (Fig. 1). At the end of HO therapy, the participants in the group with oxygen were divided into the efficacy group if the isthmus Z-score ≥−2 and the inefficacy group if the isthmus dimension Z-score 0.05). Compared with the efficacy group, left heart dimension Z-scores were the same prior to HO therapy (P > 0.05) but were significantly smaller at 4, 8, and 12 weeks post-HO therapy (P < 0.05, Fig. 3).

Discussion

Materials and Methods

Conclusions