FETAL CARDIAC FUNCTION ASSESSED BY M - MODE ANNULAR EXCURSION IN IUGR FETUSES

Abstract

Introduction: Fetal growth restriction (FGR) affects 5-10% of pregnancies and is associated with increased risk of perinatal morbidity, mortality and long term complications. Heart is the central organ in the prenatal adaptation to placental insufficiency and fetal hypoxia leading to cardiac remodeling. It causes changes in cardiac shape subclinical cardiac dysfunction and vascular remodeling. Longitudinal myocardial motion is a sensitive early parameter for the indication of subclinical dysfunction in utero and can be assessed by M-mode. Here in this study we evaluated MAPSE for identifying high risk group among IUGR fetuses who could be targeted for early detection of cardiovascular dysfunction.

Materials and Methods: Foetal echocardiacography was done to evaluated mitral valve displacement by M - mode and was compared between IUGR and normal growth babies. Neonatal outcome were also recorded and compared

Results: 40 cases each were taken in the study and the control group. IUGR fetuses had abnormal fetoplacental doppler parameters. Mitral annular plane systolic excursion was reduced in IUGR babies as compared to normal fetuses.

Conclusion: IUGRfetuses present signs of subclinical cardiac dysfunction. Early identification of high risk groups among the IUGR fetuses, who are at an increased cardiovascular risk can be identified by applying functional fetal echocardiography in routine practice.

Keywords: FGR, Fetoplacental Doppler, M - mode, MAPSE.