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Ultrasound/Imaging

Poster Session 4

(1116) The profile of fetuses with growth restriction with and without growth recovery

Wednesday, February 14, 2024

1:00 PM – 2:30 PM

Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

Primary & Presenting Author(s)

Manesha Putra, MD (he/him/his)

Assistant Professor
University of Colorado
Aurora, CO, United States

Coauthor(s)

Emma E. Peek, BS (she/her/hers)

University of Colorado
Denver, CO, United States
Greggory R. DeVore, MD

Clinical Professor
University of California Los Angeles, David Geffen School of Medicine
Pasadena, CA, United States
JH

John Hobbins, MD

University of Colorado
Denver, CO, United States

Objective: We aimed to compare the cardiac size and shape and functional parameters, thigh volumes, and neurodevelopmental outcomes of growth restricted fetuses whose estimated fetal weight (EFW) and abdominal circumference (AC) later exceed the 10^th percentile.

Study Design: This was a retrospective cohort study of singleton non-anomalous pregnancies with fetal growth restriction initially diagnosed after 20 weeks of gestation. Fetuses who then had growth recovery define as EFW and AC greater than 10^th percentile were compared to the growth restricted cohort. Cardiac size, shape, and functional parameters were obtained using speckle tracking. Thigh volumes calculation were measured using 3-dimentional ultrasound and calculated according to Lee et al. Bayley-III scores were measured at 2-3 years of age. The percentiles of these parameters were compared using Mann-Whitney U tests.

Results: There were a total of 95 fetuses included in the cohort with 15 (15.8%) who showed growth recovery and 80 (84.2%) who remained growth restricted. Cardiac data was available in 95 patients, thigh volume data was available in 75 patients, and Bayley-III scores were available in 34 patients. There were no differences in size and shape, and functional parameters between the recovered and growth restricted cohorts except for a decreased fractional left ventricular shortening of segment 12 (L FS T12) percentile (Figure 1a). Left ventricular cardiac output (LVCO) was < 10% for both groups. Total thigh and lean thigh volumes were smaller in growth restricted cohort (Figure 1b). The recovered growth children had higher motor and language percentiles on the Bayley-III (Figure 1c).

Conclusion: Traditionally, growth recovery in growth restricted fetuses may result in reduced to no surveillance given the perceived overall improved outcomes in this group. While thigh volumes and neurodevelopmental outcomes were improved in the recovered group, cardiac parameter similarity and low LVCO in both the recovered and growth restricted groups may suggest residual risk to the recovered growth fetuses.