Congenital Heart Disease Fetuses Have Decreased Mid-Gestational Placental Flow, Placental Malperfusion Defects, and Impaired Growth

• DOI: 10.1016/j.jacadv.2024.101559
• Publication Date: 2025-01-18T19:52:47Z
• Authors: Rebecca Josowitz; Deborah Y. Ho; Somya Shankar; Antara Mondal; Alexis Zavez; Rebecca L. Linn; Zhiyun Tian; J. William Gaynor; Jack Rychik
• Keywords: Placental Circulation

Placental health may impact the development and outcomes of congenital heart disease (CHD). CHD fetuses have been shown retrospectively to decreased placental blood flow. The purpose this study was determine if with flow pathology at birth there is a relationship between flow, pathology, outcomes. We performed prospective case-control 38 fetuses, including 28 single ventricle physiology 36 controls. Demographic, clinical, postnatal biometric data were collected. Umbilical venous volume (UVVF) measured from 2nd trimester fetal echocardiograms. Placentas underwent standardized pathological analysis. Standard descriptive statistics regression analyses analyze UVVF, defects, had 15% decrease in mid-gestational UVVF indexed weight (P < 0.01), 27% reduction as proportion cardiac output 0.01) compared increased maternal vascular malperfusion (MVM) lesions (44% vs 18%, P 0.05), especially high-grade MVM (39% 9.1%, = trend toward (42% 23%, 0.10). but not associated 0.001). There no association pathologic findings or growth. (particularly ventricle) impaired influence growth CHD.