Fetal major cardiac defects and placental dysfunction at 11-13 weeks' gestation

Journal article


Fantasia, I., Kasapoglu, D., Kasapoglu, T., Syngelaki, A., Akolekar, R. and Nicolaides, K. H. 2018. Fetal major cardiac defects and placental dysfunction at 11-13 weeks' gestation. Ultrasound in Obstetrics and Gynecology. 51 (2), pp. 194-198. https://doi.org/10.1002/uog.18839
AuthorsFantasia, I., Kasapoglu, D., Kasapoglu, T., Syngelaki, A., Akolekar, R. and Nicolaides, K. H.
Abstract

Objectives: To investigate the relationship between fetal major cardiac defects and markers of placental perfusion and function.

Methods: This was a prospective screening study in singleton pregnancies at 11-13 weeks’ gestation. Uterine artery pulsatility index (UTPI), serum pregnancy associated plasma protein-A (PAPP-A) and placental growth factor (PLGF) were measured and the values were converted into multiples of the normal median (MoM). Median MoM values in fetuses with isolated major cardiac defects were compared to those in fetuses without major defects.

Results: The 50,094 singleton pregnancies fulfilling the entry criteria included 49,898 pregnancies with a normal cardiac anatomy and 196 (0.39%) with major congenital cardiac defects; 73 (37.2%) with conotruncal defects, 63 (32.1%) with left ventricular outflow tract (LVOT) defects and 60 (30.6%) with valvular defects. In the group of cardiac defects, compared to controls, there was lower median PAPP-A MoM (0.81 vs 1.00, p<0.0001) and PLGF MoM (0.78 vs 1.00, p<0.0001) but no significant difference in UTPI MoM (1.01 vs 1.00, p=0.162).

Conclusions: In pregnancies with isolated major cardiac defects there is evidence of placental dysfunction in the absence of impaired placental perfusion.

KeywordsCongenital heart defect; First trimester screening; Placental growth factor; Pregnancy associated plasma protein-A; Uterine artery Doppler
Year2018
JournalUltrasound in Obstetrics and Gynecology
Journal citation51 (2), pp. 194-198
PublisherWiley
ISSN0960-7692
Digital Object Identifier (DOI)https://doi.org/10.1002/uog.18839
Official URLhttps://doi.org/10.1002/uog.18839
FunderFetal Medicine Foundation
Publication dates
Online08 Jan 2018
Publication process dates
Accepted08 Aug 2017
Deposited28 May 2020
Accepted author manuscript
Output statusPublished
Additional information

Fetal Medicine Foundation. Grant Number: 1037116

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