Severity of Fetal Brain Abnormalities in Congenital Heart Disease in Relation to the Main Expected Pattern of in utero Brain Blood Supply

2015 ◽  
Vol 39 (4) ◽  
pp. 269-278 ◽  
Author(s):  
Narcís Masoller ◽  
Magda Sanz-Cortés ◽  
Fàtima Crispi ◽  
Olga Gómez ◽  
Mar Bennasar ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Blood Supply ◽  
Congenital Heart ◽  
Cortical Development ◽  
Fetal Brain ◽  
Fetal Mri ◽  
In Utero ◽  
Class A ◽  
Severe Reduction

Objectives: We evaluated the hypothesis that in fetuses with congenital heart disease (CHD) there is a correlation between the expected pattern of in utero brain blood supply and the severity of neurodevelopmental impairment. Methods: A total of 58 fetuses with CHD and 58 controls underwent a Doppler ultrasound and fetal MRI at 36-38 weeks. Fetuses with CHD were divided into two functional classes: class A with an expected severe reduction in oxygenated brain blood supply (left outflow tract obstruction and transposition of great vessels) and class B with theoretically near-normal or mildly impaired oxygenated brain blood supply (other CHD). Head biometry and cerebroplacental Doppler were assessed by ultrasound, and brain volumetry, cortical development and metabolism by MRI. Results: Both class A and B CHD fetuses had significant differences in head biometry, brain perfusion, cortical development and brain metabolism compared with controls. However, there was a significant linear tendency for head biometry, cerebral Doppler, volumes, cortical sulcation and metabolic ratios across the three clinical groups, with signs of more severe brain alterations in type A CHD fetuses. Conclusions: All fetuses with CHD showed significant brain developmental changes, but differences were more pronounced in CHD associated with an expected severe reduction in oxygenated blood supply to the brain.

Abstract 17204: Asymmetric Patterns of Cerebral Cortical Development in Fetuses With Complex Congenital Heart Disease

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Yuanchiao Lu ◽  
Kushal Kapse ◽  
Nicole Andersen ◽  
Catherine Lopez ◽  
Jessica Quistorff ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Fetal Brain ◽  
Fetal Mri ◽  
Complex Congenital Heart Disease ◽  
Single Shot ◽  
Healthy Controls ◽  
Hemispheric Asymmetries ◽  
The Right

Introduction: Neurodevelopmental disabilities are common among infants with complex congenital heart disease (CHD). While hemispheric asymmetries in normal fetal brain size and shape have been reported, the effect of CHD on hemispheric development of the developing fetal brain remains unknown. Hypothesis: We hypothesized that emerging cerebral hemispheric asymmetries of the fetal CHD brain would differ compared to healthy controls using in vivo MRI tools. Methods: A total of 252 pregnant women were recruited (164 controls; 88 CHD fetuses), in which 328 fetal MRI scans were performed. Single shot fast spin echo T2-weighted images were acquired on a 1.5T GE MRI scanner. High-resolution 3D models of the fetal brain were reconstructed using slice-to-volume registration method for motion correction and Draw-EM algorithm for automatic segmentation. Volumetric analysis of brain tissues was conducted, and cortical folding measures of brain lobes were evaluated. Mixed effects regression was utilized to compare the brain features between right and left hemispheres for healthy controls and CHD fetuses. Results: The mean gestational age of all fetal MRI studies was 32.1±3.7 weeks (range: 24.0-39.4). For healthy fetuses, the volume of cortical gray matter was higher in the left hemisphere; however, this pattern was diminished in CHD fetuses. Gyrification indices were higher in the parietal and occipital lobes of the right hemisphere for controls, but not for CHD fetuses. Similarly, Gaussian curvature was higher in the right frontal lobe for controls only. Conversely, the surface area of the left occipital lobe was lower in CHD fetuses, but not in healthy fetuses. Conclusions: We report for the first time early disturbances in emerging hemispheric asymmetric patterns of the fetal brain in CHD compared to controls. The extent to which these lateralization differences reflect genetic, epigenetic and/or hemodynamic disturbances in CHD fetuses is under investigation.

scholarly journals Increasing Lung Blood Supply in Congenital Heart Disease

BMJ ◽  
1949 ◽  
Vol 1 (4607) ◽  
pp. 699-702 ◽  
Author(s):  
N. R. Barrett ◽  
R. Daley
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Blood Supply ◽  
Congenital Heart

Abstract 16738: Association Between First and Second Trimester Maternal Screening Biochemistry, Ultrasound, and Fetal Brain Growth in Presence of Fetal or Maternal Congenital Heart Disease

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Aman Sharma ◽  
Emma Lewis ◽  
Gabrielle Gray ◽  
Jennifer R Maldonado ◽  
Diana L Knoedel ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Fetal Brain ◽  
Nuchal Translucency ◽  
Second Trimester ◽  
Fetal Head ◽  
Placental Dysfunction ◽  
Z Scores ◽  
Hormonal Levels

Introduction: Newer research has highlighted significant neurological impairments in children and adults with congenital heart disease (CHD). The more severe the heart defect, the higher the neurologic impairment. Pregnancies complicated by fetal or maternal CHD carry a higher risk of placental abnormalities. We studied the association between pregnancy hormonal levels and fetal head and body growth. Hypothesis: Placental dysfunction in pregnancies with fetal or maternal CHD alters pregnancy hormonal levels affecting fetal brain and somatic growth. Methods: We performed a retrospective case-control study on pregnant women (year 2010-2019) at the University of Iowa. Only women with first and/or second trimester prenatal screening (ultrasound and blood test) were included. Pregnancies with fetal chromosomal abnormalities, multiple gestation, maternal diabetes, smoking, or hypertension were excluded. Pregnancies were either healthy controls (n=36), women with CHD (MCHD; n=26), or fetus with CHD (FCHD; n=23). Pregnancy hormonal levels, ultrasound findings, and fetal/neonatal growth percentiles and/or z-scores data were analyzed. Results: Women with CHD were younger (p=0.004) with increased fetal nuchal translucency (p=0.003) compared to controls. Women in MCHD (p=0.02) and FCHD (p=0.02) group delivered earlier than controls. FCHD had significantly lower pregnancy associated plasma protein-A (PAPP-A) levels than controls (p=0.04). The groups had no difference in the second trimester fetal head circumference (HC) and femur length. FCHD group had significantly smaller HC percentile (p=0.03) and z-scores (p=0.03) at birth than controls. Both FCHD and MCHD had smaller birth weight and length compared to controls. However, only FCHD group demonstrated significantly lower HC to birth weight ratio (p=0.01). The controls had a positive correlation between human chorionic gonadotropin level and head circumference z-score at birth (r=0.34;p=0.053). Conclusions: Pregnant women with CHD have increased fetal nuchal translucency and deliver at earlier gestational age. Women with fetal CHD have smaller neonatal head and body size at birth with associated low PAPP-A level early in their pregnancy probably related to placental dysfunction.

scholarly journals Delayed Cortical Development in Fetuses with Complex Congenital Heart Disease

2012 ◽  
Vol 23 (12) ◽  
pp. 2932-2943 ◽  
Author(s):  
C. Clouchoux ◽  
A. J. du Plessis ◽  
M. Bouyssi-Kobar ◽  
W. Tworetzky ◽  
D. B. McElhinney ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Cortical Development ◽  
Complex Congenital Heart Disease

FUNCTIONAL ASPECTS OF CONGENITAL HEART DISEASE IN UTERO

1994 ◽  
Vol 22 (s1) ◽  
pp. 51-53
Author(s):  
M. Marasini ◽  
A. Rimini ◽  
F. Conti ◽  
G. Pongiglione
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
In Utero ◽  
Functional Aspects

OP06.13: Current outcome of congenital heart disease diagnosed in utero

2007 ◽  
Vol 30 (4) ◽  
pp. 475-476
Author(s):  
D. Prandstraller ◽  
A. Perolo ◽  
A. Donti ◽  
G. D. Gargiulo ◽  
F. M. Picchio ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
In Utero

370: Timing of arrested fetal brain growth in congenital heart disease (CHD)

2012 ◽  
Vol 206 (1) ◽  
pp. S173
Author(s):  
Ozhan M. Turan ◽  
Sifa Turan ◽  
Julia Dovgun ◽  
Ulrich Gembruch ◽  
Chris Harman ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Fetal Brain ◽  
Brain Growth

Umbilical Cord Blood Gas in Newborns with Prenatal Diagnosis of Congenital Heart Disease: Insight into In-Utero and Delivery Hemodynamics

2019 ◽  
Vol 40 (8) ◽  
pp. 1575-1583
Author(s):  
April D. Adams ◽  
Nimisha Aggarwal ◽  
Sara N. Iqbal ◽  
Lauren Tague ◽  
Kami Skurow-Todd ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Prenatal Diagnosis ◽  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Congenital Heart ◽  
In Utero ◽  
Blood Gas ◽  
Insight Into
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