TY - JOUR AU - Graupner, Oliver; Koch, Jessica; Enzensberger, Christian; Götte, Malena; Wolter, Aline; Müller, Vera; Kawecki, Andreea; Herrmann, Johannes; Axt-Fliedner, Roland TI - Cerebroplacental and Uterine Doppler Indices in Pregnancies Complicated by Congenital Heart Disease of the Fetus TT - Cerebroplazentare und uterine Dopplerwerte in Schwangerschaften mit fetalem kongenitalem Herzfehler SN - 0172-4614 SN - 1438-8782 PY - 2021 JO - Ultraschall Med JF - Ultraschall in der Medizin - European Journal of Ultrasound LA - DE VL - 42 IS - 01 SP - 48 EP - 55 ET - 2019/06/14 DA - 2021/02/02 KW - fetal Doppler KW - fetal echocardiography KW - uterine Doppler KW - congenital heart disease AB - Purpose Children with congenital heart disease (CHD) are known to have impaired neurodevelopment possibly influenced by altered cerebroplacental hemodynamics antenatally. We compared fetomaternal Doppler patterns in different CHD groups with published normative values during gestation.Materials and Methods Retrospective cohort study consisting of 248 CHD fetuses. Subgroups were generated according to the expected ascending aorta oxygen saturation: low portion of high oxygenated umbilical venous (UV) blood (group 1: n = 108), intermediate portion of UV blood due to intracardiac mixing with oxygen poor systemic blood (group 2: n = 103), high (group 3: n = 13) and low portion of UV blood without mixing of blood (group 4: n = 24). Doppler examination included umbilical artery and middle cerebral artery pulsatility index (UA-PI, MCA-PI), cerebroplacental ratio (CPR) and mean uterine artery (mUtA) PI. For mean comparisons at different gestational ages (GA), estimated marginal means from regression models are reported for GA 22 weeks (wks), GA 30 wks and GA 38 wks.Results Z-score transformed values of MCA-PI (zMCA-PI) were significantly lower in group 1 compared to all other subgroups at GA 30 wks (p < 0.05). At 38 wks, group 1 had significantly lower values of zMCA-PI and zCPR compared to groups 2 and 4. Group 1 fetuses showed a significant association between zMCA-PI and zCPR (negative) and GA as well as zmUtA-PI (positive) and GA compared to reference values.Conclusion Our data confirm that CHD fetuses have a higher rate of cerebral redistribution in the third trimester. Changes in Doppler patterns were mainly observed in CHD with a low portion of UV blood in the ascending aorta. PB - Georg Thieme Verlag KG DO - 10.1055/a-0900-4021 UR - http://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-0900-4021 ER -