VP23.06: Effect on fetal circulation and cardiac function in the fetuses with fetal growth restriction

Fetal growth restriction (FGR) is associated with an adverse impact on fetal circulation and fetal cardiac function due to placental insufficiency. Intraventricular pressure difference (IVPD) is known as a parameter for diastolic function which represents the early active diastolic suction from the basal to the apex. Our objective was to elucidate the effects on fetal circulation and cardiac function in FGR fetuses. We prospectively recruited 57 FGR cases at our hospital from 2015 to 2021. FGR was confirmed as the birth weight (BW) less than -2.0SD. IVPD was collected with colour M-mode which was subsequently analysed with our own program on Matlab. Fetal Doppler data such as middle cerebral artery (MCA) pulsatility index (PI), umbilical arterial (UA) PI, ductus venosus (DV) PI and cardiac functional parameters (Tei index, E/A ratio, isovolumetric relaxation time (IRT)) were collected. The relationship between BW and each parameter was analysed with Spearman correlation coefficient. IVPD in right ventricles (RV) showed a positive correlation to BW (P = 0.009, r = 0.475), but not IVPD in left ventricles (LV). Indeed, there was a negative correlation between DV-PI and BW (p < 0.001, r = -0.501). Cerebral placental ratio (CPR) was calculated by UA-PI/MCA-PI. There was no significant correlation between CPR and BW. About cardiac function, there was a negative correlation between E/A ratio and BW (P = 0.007, r = -0.480). Other cardiac parameters did not show significant correlations. DV-PI was the most effective parameter to predict severe FGR cases as previously described. IVPD in RV might be one marker for cardiac function to evaluate severe FGR.