Evaluation of Fetal Cardiac Functions in Prolonged Pregnancy. A Fetal Echocardiographic

Background: Prolonged pregnancy is associated with high incidence of perinatal morbidity and mortality. Understanding the mechanisms that lead to oligohydramnios and abnormal fetal heart rate pattern may prove to be useful for diagnosis, follow-up and management. Little information exists regarding fetal cardiac function in prolonged pregnancy. Aim of the Work: The aim of our study was to evaluate the hypothesis that prolonged pregnancy is associated with deterioration of fetal cardiac performance. Patients and Methods: This is a cross-sectional study included ninety five pregnant ladies uncomplicated, singleton pregnancy. Fifty two ladies were at term (37-40 weeks) and 43 were more than 41 weeks. Abdominal ultrasound was done to assess amount of amniotic fluid and gestational age. Doppler study of fetal umbilical artery was done to exclude cases with abnormal placental blood flow. Fetal echocardiography studies were performed using Doppler and M-mode sonography. Left ventricular dimensions, systolic and diastolic functions, stroke volume as well as cardiac output were assessed. Fetal heart rate pattern and amniotic fluid index were recorded. Results: Prolonged pregnancy is associated with reduced fetal cardiac output by using both Doppler and M-mode fetal echocardiography techniques. Deteriorated Left ventricular diastolic compliance and systolic ejection were correlated significantly with oligohydramnios and abnormal fetal heart rate pattern. Conclusion: These findings suggested that fetal cardiac function is impaired in prolonged pregnancy that might play a role in increased perinatal morbidity and mortality in prolonged pregnancy.