Objective
To compare the fetal cardiac morphology and functions of early‐onset fetal growth restriction (EO‐FGR) and late‐onset fetal growth restriction (LO‐FGR) groups with gestational weeks‐matched controls.
Methods
A total of 164 pregnant women were included, 28 of whom were in the EO‐FGR group, 54 in the LO‐FGR group, and 82 in the control group. Fetal echocardiographic evaluation was performed with two‐dimensional, M‐mode, tissue Doppler imaging (TDI), and pulsed wave Doppler.
Results
Fetal cardiac morphologic measurements and diastolic and systolic functions changed in EO‐FGR and LO‐FGR fetuses compared with controls. The EO‐ and LO‐FGR fetuses had reduced right and left cardiac output, increased myocardial performance index, and significantly higher mitral and tricuspid E/E' ratios compared with controls. The EO‐FGR fetuses had lower mitral and tricuspid E and E' values. In LO‐FGR fetuses, mitral and tricuspid E' values were lower than in their controls (P = 0.001 and P < 0.001). On the other hand, the mitral and tricuspid E values were not significantly changed (P = 0.107 and P = 0.196).
Conclusion
We hypothesized that EO‐FGR and LO‐FGR fetuses had insufficient myocardial maturation. Especially in the LO‐FGR fetuses, TDI is the earliest and most sensitive technique to show subtle changes in fetal cardiac functions.