The role of 4D ultrasound (STIC mode with VOCAL technique) in evaluation of the fetal cardiac ventricular function in intra uterine growth-restricted fetuses with increased placental impedance
Abstract Background The fetal heart is one of the principal organs involved in adaptive responses to placental insufficiency, particularly in cases of intrauterine growth restriction (IUGR). Cardiovascular diseases remain the leading cause of mortality worldwide, and increasing evidence suggests tha...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2025-07-01
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| Series: | The Egyptian Journal of Radiology and Nuclear Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43055-025-01532-y |
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| Summary: | Abstract Background The fetal heart is one of the principal organs involved in adaptive responses to placental insufficiency, particularly in cases of intrauterine growth restriction (IUGR). Cardiovascular diseases remain the leading cause of mortality worldwide, and increasing evidence suggests that a suboptimal prenatal environment contributes to the development of cardiometabolic complications later in life. This study aims to evaluate whether fetuses with increased placental vascular impedance in the context of IUGR exhibit alterations in cardiac ventricular function. Spatiotemporal image correlation (STIC) and Virtual Organ Computer-aided Analysis (VOCAL) were employed for detailed functional assessment. This analytic case–control study was conducted on 37 patients between August 2020 and August 2021 at a specialized female imaging unit. Ultrasound examination, including Doppler evaluation of placental and fetal circulations, was performed, followed by assessment of fetal cardiac ventricular volumes using the VOCAL technique in STIC mode. Ventricular parameters—including end-systolic volume (ESV), end-diastolic volume (EDV), stroke volume, cardiac output (CO), adjusted CO, and ejection fraction (EF)—were measured and compared between fetuses with increased placental vascular impedance and those with normal growth. Results Twenty IUGR fetuses diagnosed with increased placental vascular impedance were evaluated at a mean gestational age of 26.1 weeks (range 20-37 weeks) The following findings were observed: decreased EDV and ESV in both the right and left ventricles; reduced CO from both ventricles; decreased CO adjusted for biometric parameters—including abdominal circumference, head circumference, and femur length—in both ventricles; and increased ventricular EF, with a predominance on the left side. Conclusion Increased placental vascular impedance to flow stimulate fetal cardiovascular programming to compensate hypoxemia and causes significant changes in fetal cardiovascular parameters and cardiac function. |
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| ISSN: | 2090-4762 |