Is Cardiomegaly an Indication of “Heart-Sparing Effect” in Small Fetuses?-Reference-Cited by-同舟云学术

Is Cardiomegaly an Indication of “Heart-Sparing Effect” in Small Fetuses?

Published:2021 Issue:10 Volume:48 Page:701-707
ISSN:1015-3837
Container-title:Fetal Diagnosis and Therapy
language:en
Short-container-title:Fetal Diagn Ther

Author:

Salvi Silvia^ORCID,D’Emidio Laura,Roughton Michael,De Carolis Sara,Lanzone Antonio,Bhide Amar,Carvalho Julene S.

Abstract

Introduction: This study aimed to test the hypothesis that cardiac size is maintained in small fetuses presenting with cardiomegaly. Materials and Methods: We identified singleton fetuses with estimated fetal weight <10th centile and with cardiomegaly without another more likely cardiac or extra-cardiac cause. We used Z-scores for cardiac and thoracic circumferences normalized for gestational age (GA), biparietal diameter (BPD), head circumference (HC), and femur length (FL), obtained from 188 normally grown fetuses. Results: When comparing chest size, small fetuses had significantly lower thoracic circumferences median Z-scores (IQR) for GA = −4.82 (−6.15 to −3.51), BPD = −2.42 (−4.04 to −1.48), HC = −2.72 (−4.53 to −1.90), and FL = −1.60 (−2.87 to −0.71); p < 0.001 for all. When comparing heart size, small fetuses showed lower cardiac circumferences median Z-scores (IQR) for GA = −1.59 (−2.79 to −0.16); p < 0.001, similar cardiac circumferences Z-scores for BPD = 0.29 (−0.65 to 1.28); p = 0.284 and HC = 0.11 (−1.13 to 0.96); p = 0.953, and higher cardiac circumferences Z-scores for FL = 0.94 (−0.05 to 2.13); p < 0.001. Conclusions: Our results show that in small fetuses with cardiomegaly, the heart maintains normal dimensions when normalized to cranial diameters and higher dimensions when normalized to long bones. This provides insight into cardiac adaptation to adverse intrauterine environment.

Publisher

S. Karger AG

Subject

Obstetrics and Gynecology,Radiology, Nuclear Medicine and imaging,Embryology,General Medicine,Pediatrics, Perinatology and Child Health

Reference32 articles.

1. Paladini D, Chita SK, Allan LD. Prenatal measurement of cardiothoracic ratio in evaluation of heart disease. Arch Dis Child. 1990;65:20–3.

2. Chaoui R, Bollmann R, Göldner B, Heling KS, Tennstedt C. Fetal cardiomegaly: echocardiographic findings and outcome in 19 cases. Fetal Diagn Ther. 1994;9(2):92–104.

3. Henrich W, Fuchs I, Bührer C, van Landeghem FK, Albig M, Stoever B, et al. Isolated cardiomegaly in the second trimester as an early sign of fetal hydrops due to intracranial arteriovenous malformation. J Clin Ultrasound. 2003;31(8):445–9.

4. Korkalainen N, Räsänen J, Kaukola T, Kallankari H, Hallman M, Mäkikallio K. Fetal hemodynamics and adverse outcome in primary school-aged children with fetal growth restriction: a prospective longitudinal study. Acta Obstet Gynecol Scand. 2017;96(1):69–77.

5. Miyague NI, Ghidini A. Effect of fetal growth restriction on ultrasonographically measured cardiac size. Early Hum Dev. 1997;48:93–8.