Skip to main content
SMFM 2024 Pregnancy Meeting Main banner
Final Program


Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Additional registration fee required
Additional registration fee required
Faculty have requested this content not be shared on social media
Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Poster Icons
Foundation Awardee
Foundation Awardee
No Social Media
No Social Media
Back
Q&A

Ultrasound/Imaging

Poster Session 4

(1177) Low maternal cardiac index is associated with a high rate of fetal growth restriction

Wednesday, February 14, 2024
1:00 PM – 2:30 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective:

A paucity of prior studies has described a relationship between maternal cardiac function and fetal growth using equipment not accessible to obstetricians. Our objective was to determine whether a low maternal cardiac index (CI) is associated with fetal growth restriction (FGR) in gravidas with and without hypertension (HTN) using a readily available adult cardiac probe compatible with obstetrical ultrasound machines.

Study Design: We conducted a prospective cross-sectional study of healthy gravidas and those with FGR with or without HTN recruited from two outpatient clinics and one antepartum hospital ward. The maternal descending aorta was imaged via the suprasternal notch using a Samsung P2-4BQ Cardiac Sector probe. The aortic diameter distal to the left subclavian artery was measured and the pulsed Doppler waveform obtained. Maximum velocity, velocity time integral, ejection time, and R-R interval were measured. Maternal CI (L/min/m2) was calculated and z-scores and their corresponding centiles were computed using a recently reported calculator derived from 400 control patients (Am J Obstet Gynecol. 2023 Aug;229(2):155.e1-155.e18.) Charts were abstracted for maternal characteristics, fetal biometry and Dopplers. Mann-Whitney and Fisher’s exact tests were used for comparisons.

Results:

Thirty-six gravidas (control 21; FGR 15) between 24-37 weeks of gestation met inclusion criteria. Two cases of FGR had chronic HTN and 1 had preeclampsia. The relationship between CI and EFW is shown in Figure 1a. Mean CI centile was significantly lower in the FGR group (control 26.8 ± 16.0 vs FGR 12.4 ± 13.0; p=.0112). In gravidas with CI < 20th centile, the rate of FGR was higher (p=.0022; Figure 1b). In the low CI FGR group, 8 of 13 (62%) had EFW < 3% and/or abnormal Dopplers.

Conclusion:

Maternal CI < 20th centile for gestational age is associated with a higher rate of FGR. Simple assessment of maternal cardiovascular parameters using a readily available adult cardiac ultrasound probe in FGR pregnancies is feasible and holds promise as a strategy for risk stratification and development of novel treatments.