Abstract
The purpose of this study was to conduct a comparative analysis of head circumference, Doppler assessment of the middle cerebral artery (MCA) and cerebroplacental ratio (CPR), as well as to assess the relationship between fetometric and Doppler parameters in groups with congenital heart disease (CHD) and healthy fetuses.
Material and methods. A retrospective case-control study included 189 patients with diagnosed fetal CHD and 708 patients with healthy fetuses (control group), who were examined at 22–40 weeks of gestation. Cerebral parameters studied included fetal head circumference, pulsation index (PI) and peak systolic velocity (PSV) in MCA and CPR.
Results. In the group of fetuses with CHD, compared with healthy fetuses, lower median values of percentile of head circumference (55.3 vs 62.8), PI in the MCA (41.5 vs 48.2) and CPR (28.3 vs 41.3) (p < 0.01) were noted. The percentage of cases with head circumference < 10th percentile, PI in the MCA and CPR < 5th percentile was significantly higher in fetuses with CHD than in the control group, amounting to 9.0% vs 3.8%, 10.6% vs 2.1%, 19.6% vs 5.4%, respectively (p < 0.01). MCC values in the MCA were significantly lower in fetuses with CHD at all gestational periods studied (p < 0.05). In both study groups, of all studied Doppler parameters, only for CPR, a direct relationship was found with the values of the fetal head circumference (p < 0.01).
Findings. Cases with CHD of the fetus are at increased risk for the presence of cerebral blood flow redistribution and slowing down the growth of the head circumference. It is necessary to introduce mandatory dynamic antenatal control of these parameters from the moment of detection of cardiac pathology to delivery, aimed at the earliest possible detection of Doppler signs of perinatal hypoxia and appropriate correction of obstetric tactics.
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About the authors
- Tamara A. Yarygina, Cand. Med. Sci., Ultrasound Doctor; ORCID
- Rena M. Gasanova, Dr. Med. Sci., Research Associate, Cardiologist; ORCID
- Elena I. Leonova, Ultrasound Doctor; ORCID
- Ol’ga V. Marzoeva, Cand. Med. Sci., Ultrasound Doctor; ORCID
- Elena V. Sypchenko, Cand. Med. Sci., Ultrasound Doctor; ORCID
- Aleksandr I. Gus, Dr. Med. Sci., Professor, Chief Researcher; ORCID
