The Changes Of Cerebrovascular Blood Flow Dynamics In Fetuses With Congenital Heart Disease

Objective: The aim of this study was to determin whether the type of congenital heart disease (CHD) or the heart function influence on fetal cerebrovascular blood flow dynamics.Methods: Doppler flow velocimetry was performed in the umbilical artery (UmA), middle cerebral artery (MCA) and the ratio of UmA-PI to MCA-PI (U/C-PI) was calculated. Fetuses with sonographically diagnosed CHD during the aforementioned time period were designated as cases. Inclusion for analysis was determined according to the type of CHD: (1) Left-sided obstructive lesions (LSOL) (n=11); (2) Right-sided obstructive lesions (RSOL) (n=16); (3) Mixed type of CHD (MTC) (n=18), and according to whether the CHD fetals complicated with or without CHF: (1) CHD complicated with CHF (n=10); (2) CHD complicated without CHF (n=35). The control group were consisted of 275 healthy fetuses matched for gestational age.Results: The CHD group had higher UmA-PI and U/C-PI when compared to the controls. There was not significant difference in MCA-PI values between the CHD group and the controls (P = 0.48); Among the diagnostic groups according to the anatomic subtypes there was not significant difference between the LSOL group and the controls(P=0.14), the RSOL group and the controls(P=0.46), the LSOL group and the RSOL group ( P=0.10), while among the diagnostic groups according to the heart function, the CHD complicated with CHF group had a lower MCA-PI when compared to the controls(P = 0.001).Conclusions: The lower pulsatility indices were observed in the middle cerebral artery of fetuses with CHD by performing Doppler flow velocimetry.The heart function and the type of CHD impacted upon the lower pulsatility indices of the middle cerebral artery.