Heart Problems Seen in Fetal Growth-Restricted Pregnancy
(HealthDay News) – Women with normotensive fetal growth-restricted pregnancies have impaired myocardial relaxation and asymptomatic diastolic dysfunction.
To investigate whether women with normotensive fetal growth-restricted pregnancies exhibit global diastolic dysfunction, Karen Melchiorre, MD, PhD, from the University of London, and colleagues conducted a prospective case-control study over three years involving 29 preterm fetal growth-restricted pregnancies, 25 preeclamptic with fetal growth restriction pregnancies, and 58 matched control pregnancies. Women were assessed at diagnosis of the complication and followed up 12 weeks postpartum.
The researchers found that a lower cardiac index and higher total vascular resistance index than expected for gestation characterized the fetal growth-restricted pregnancies. Fetal growth-restricted pregnancy correlated with significantly increased widespread impaired myocardial relaxation (59 vs.21%) and prevalence of asymptomatic left ventricular diastolic dysfunction (28 vs.4%), compared with controls. In fetal growth-restricted pregnancy, unlike preeclampsia, cardiac geometry and intrinsic myocardial contractility were preserved. A low output, high resistance circulatory state; a higher prevalence of asymptomatic global diastolic dysfunction; and poor cardiac reserve characterized fetal growth-restricted pregnancies.
"These findings may explain the increased long-term cardiovascular risk in these women who have had fetal growth-restricted pregnancies," the authors write. "Further studies are needed to clarify the postnatal natural history of cardiac dysfunction in these women."