Human fetal cardiovascular profile score and neonatal outcome in intrauterine growth restriction

Abstract

Objective To determine whether low cardiovascular profile (CVP) (28 (range, 24-35) weeks vs. 35 (range, 26-40) weeks, P < 0.01) and had lower CVP scores (4 (range,[2][3][4][5][6][5][6][7][8][9][10], P < 0.0001). All CVP subscale scores were lower (P < 0.01) in Group 1 than in Group 2 fetuses. Gestational age-adjusted hazard ratios (95% CIs) for adverse neonatal outcome were highest for cardiomegaly (13.9 (1.7-114.3), P = 0.014), monophasic atrioventricular filling pattern or holosystolic tricuspid regurgitation (9.5 (2.3-38.4

Diagnosis and Treatment of Fetal Cardiac Disease

“…Finally, fetal hypoxia secondary to more severe placental insufficiency may also contribute to myocardial dysfunction. 226,227 Although the assessment of fetal heart function is one of the main functions of the fetal echocardiogram, consensus does not exist as to the extent to which such an evaluation, whether qualitative or quantitative, should be done, particularly as part of the basic fetal echocardiogram. A qualitative assessment of heart function is recommended as part of a fetal echocardiogram; however, a wide variety of approaches for the evaluation of fetal cardiac function are available and may be useful, particularly in certain disease processes as outlined below and elsewhere in this document (Table 6).…”

“…Scoring of the 5 categories (2 points for each), including hydrops, venous Doppler, heart size, heart function, and arterial Doppler, has been studied as it relates to prognosis in fetuses with hydrops, CHD, and growth restriction. 226,245,246 The CVP score may be useful in the baseline and serial evaluations for fetuses at risk for or with myocardial dysfunction. Finally, abnormalities of myocardial structure and function may affect the fetal circulation, including placental blood flow and fetal growth, 247 and conversely, placental pathology may contribute to fetal hemodynamic compromise through fetal hypoxia.…”

“…Finally, abnormalities of myocardial structure and function may affect the fetal circulation, including placental blood flow and fetal growth, 247 and conversely, placental pathology may contribute to fetal hemodynamic compromise through fetal hypoxia. 226,227 The assessment of umbilical artery pulsatility may be useful in these conditions. Recent experience has also suggested that fetal cardiac pathology can influence cerebral blood flow.…”

The (Pulsed-Wave) Doppler Fetal Myocardial Performance Index: Technical Challenges, Clinical Applications and Future Research

“…Most available studies of fetal cardiac function have failed to show an individual marker reliable enough in providing information on sequential changes of the cardiac performance [139,140]. Most of the volumetric evaluations are influenced by the heart rate, peripheral resistance and blood volume.…”

Role of quantitative assessment in fetal echocardiography

“…Caution, however, must be exercised in the use of a uniform scoring system for different disease states, as has been proposed for the cardiovascular score developed for fetal heart failure 23,24 and a recent modification and application of this score to TTTS recipient and donor twins 25 . Although the cardiovascular score for heart failure correlates with fetal loss among highrisk pregnancies, it has been used for both primary cardiac disease 24 , in which myocardial dysfunction leads to worse outcome, and for placental insufficiency 25 , in which fetal hypoxia is the trigger for late and often acute onset (secondary) reduced myocardial function.…”