ASSESSMENT OF CARDIAC SPARING EFFECT IN INTRAUTERINE GROWTH RESTRICTED FETUSES: A PROSPECTIVE COHORT STUDY
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Abstract
Objective: The study aimed to find a difference in the cardiac output (COP) between normal and intrauterine growth restricted (IUGR) fetuses and to clarify a heart-sparing effect in IUGR fetuses (a new issue).
Material and methods: This single-center, prospective cohort study, was conducted at Assiut Woman's Health University Hospital, Egypt, prospectively registered at clinical trial.gov NCT03146507. Two hundred and ten women were included: women with normal pregnancy (Group A:N=105) and women whose pregnancy was complicated by IUGR between 32 to 34 weeks gestation(Group B:N=105) from 2017 to 2022. Women underwent fetal Doppler echocardiography, umbilical (UA), and middle cerebral (MCA) artery Doppler assessment. The primary outcome included the relative cardiac output ratio at 32-34 weeks. Changes in Doppler indices in the UA and MCA were also recorded. Data were analyzed by unpaired Student's t-test and Chi-square test.
Results: At 32-34 weeks and from 34 to 36 weeks; there was a higher value of right-side cardiac output in group A compared with group B; with a statistically significant difference (p=<0.001). While; the left-sided cardiac output was comparable in both groups; it was significantly higher in the IUGR group from 34 to 36 weeks.
Conclusion: There are significant changes in the cardiac output in IUGR fetuses in late pregnancy as compared with normal pregnancy thus confirming the hypothesis of heart sparing phenomenon.