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Does pre-eclampsia influence fetal cardiovascular function in early-onset intrauterine growth restriction?

  1. F. Crispi,
  2. M. Comas,
  3. E. Hernández-Andrade,
  4. E. Eixarch,
  5. O. Gómez,
  6. F. Figueras,
  7. E. Gratacós*

Article first published online: 13 OCT 2009

DOI: 10.1002/uog.7450

Issue

Ultrasound in Obstetrics & Gynecology

Ultrasound in Obstetrics & Gynecology

Volume 34, Issue 6, pages 660–665, December 2009

Additional Information

How to Cite

Crispi, F., Comas, M., Hernández-Andrade, E., Eixarch, E., Gómez, O., Figueras, F. and Gratacós, E. (2009), Does pre-eclampsia influence fetal cardiovascular function in early-onset intrauterine growth restriction?. Ultrasound Obstet Gynecol, 34: 660–665. doi: 10.1002/uog.7450

Author Information

  1. Maternal–Fetal Medicine Department, Institut Clinic de Ginecologia, Obstetricia i Neonatologia (ICGON), Hospital Clinic, Fetal and Perinatal Medicine Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain

*Department of Maternal–Fetal Medicine (ICGON), Hospital Clínic, Sabino de Arana 1, 08028, Barcelona, Spain

Publication History

  1. Issue published online: 1 DEC 2009
  2. Article first published online: 13 OCT 2009
  3. Manuscript Accepted: 7 MAY 2009

Funded by

  • Fondo de Investigación Sanitaria. Grant Numbers: PI/060347, PI/0690152
  • Cerebra Foundation for the Brain Injured Child
  • Thrasher Research Fund
  • Carlos III Institute of Health. Grant Number: CM07/00076

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Keywords:

  • B-type natriuretic peptide;
  • cardiovascular function;
  • echocardiography;
  • IUGR;
  • pre-eclampsia

Abstract

Objectives

Increasing evidence shows that intrauterine growth restriction (IUGR) is associated with fetal cardiac dysfunction. Most studies group IUGR with and without pre-eclampsia (PE) altogether. Our objective was to evaluate whether the association with PE has any impact on cardiac function in IUGR fetuses

Methods

Thirty-one normotensive IUGR cases and 31 IUGR cases with pre-eclampsia (PE + IUGR) below 34 weeks of gestation were included. IUGR was defined as a birth weight below the 10th centile together with an umbilical artery pulsatility index above 2 SD. Fetal cardiac function was assessed by measuring ductus venosus pulsatility index, modified myocardial performance index, aortic isthmus blood flow, E/A ratios and cardiac output. The presence of fetal cardiac dysfunction was also assessed by measuring cord blood B-type natriuretic peptide (BNP) levels collected at birth. Echocardiographic data were compared with those in 80 term appropriate-for-gestational age (AGA) fetuses from normotensive mothers. Cord blood BNP levels were compared with those in 40 AGA cases that delivered preterm.

Results

All IUGR cases (with or without PE) showed echocardiographic and biochemical signs of cardiac dysfunction compared with AGA cases. However, no differences were observed between IUGR and PE + IUGR cases either in echocardiographic or in biochemical parameters. IUGR cases with or without PE had similar perinatal results.

Conclusions

IUGR fetuses showed echocardiographic and biochemical signs of cardiac dysfunction. Pre-eclampsia per se does not influence cardiac function in IUGR fetuses. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.

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