Maternal cardiac function in fetal growth restriction


Prof. KH Nicolaides, Harris Birthright Research Centre for Fetal Medicine, King’s College Hospital, Denmark Hill, Golden Jubilee Wing, London SE5 9RS, UK. Email


Objective  To assess the maternal central haemodynamics in normotensive women with pregnancies complicated by severe fetal growth restriction (FGR).

Design  Cross-sectional study.

Setting  A tertiary referral fetal medicine unit.

Population  The study groups comprised 107 women with normal singleton pregnancies and 20 with singleton pregnancies complicated by FGR at 25–37 weeks. In the latter group, assessment was carried out within 10 days prior to their delivery. All the women were normotensive, without any medical problems.

Methods  Two-dimensional and M-mode echocardiography of the left ventricle.

Main outcome measures  Maternal left ventricular systolic and diastolic function.

Results  In the FGR group, compared with the normal group, there was increased total vascular resistance (TVR), reduced systolic function characterised by lower cardiac output, stroke volume, heart rate, ejection time and septal and lateral long-axis shortening. Mean arterial pressure (MAP) was not significantly different between the groups.

Conclusions  Severe FGR is associated with reduced maternal systolic function and increased TVR but no change in MAP. TVR may be a useful tool in the classification and management of FGR. The findings suggest that in FGR, there is increased blood viscosity due to lack of intravascular space expansion.