Characterization of hemodynamic patterns in human fetuses wi
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The study shows that fetuses with cyanotic congenital cardiac malformations exhibit profound changes in the distribution of blood flow and oxygen transport which result in changes in cerebral, pulmonary and placental blood flow and oxygenation.

The objective was to characterize the distribution of blood flow and oxygen transport in human fetuses with congenital heart disease (CHD) subtypes that present with neonatal cyanosis?using magnetic resonance imaging (MRI).

Blood flow was measured in the major vessels of 152 late gestation human fetuses with CHD and 40 gestational age-matched normal fetuses using cine phase contrast MRI. Oxygen saturation (SaO2) was measured in the major vessels of 57 fetuses with CHD and 40 controls.

--Compared with controls, they found lower combined ventricular output in fetuses with single ventricle physiology, with the lowest observed in fetuses with severe forms of Ebstein's?Anomaly.

--Obstructive lesions of the left or right heart exhibited increases in flow across the contralateral side.

--Pulmonary blood flow was reduced in fetuses with Ebstein's Anomaly, while fetuses with Ebstein's anomaly and tricuspid atresia had reduced umbilical flow.

--Superior vena cava flow was elevated in fetuses with transposition, normal in fetuses with hypoplastic left heart, tetralogy of Fallot and tricuspid atresia, and reduced in fetuses with Ebstein's?Anomaly.

--Umbilical vein SaO2 was lower in fetuses with hypoplastic left heart and tetralogy of Fallot. Ascending aorta and superior vena cava SaO2 were lower in nearly all CHD subtypes.

These alterations of fetal circulatory physiology may influence their neonatal course and help account for abnormalities of prenatal growth and development that have been described in newborns with cyanotic CHD.

Ultrasound in Obstetrics & Gynecology
Source: https://doi.org/10.1002/uog.23707
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