Maternal cardiac function in fetal growth restriction

OBJECTIVE: To assess the maternal central haemodynamics in normotensive women with pregnancies complicated by severe fetal growth restriction (FGR). DESIGN: Cross-sectional study. SETTING: A tertiary referral fetal medicine unit. POPULATION: The study groups comprised 107 women with normal singleton pregnancies and 20 with singleton pregnancies complicated by FGR at 25-37 weeks. In the latter group, assessment was carried out within 10 days prior to their delivery. All the women were normotensive, without any medical problems. METHODS: Two-dimensional and M-mode echocardiography of the left ventricle. MAIN OUTCOME MEASURES: Maternal left ventricular systolic and diastolic function. RESULTS: In the FGR group, compared with the normal group, there was increased total vascular resistance (TVR), reduced systolic function characterised by lower cardiac output, stroke volume, heart rate, ejection time and septal and lateral long-axis shortening. Mean arterial pressure (MAP) was not significantly different between the groups. CONCLUSIONS: Severe FGR is associated with reduced maternal systolic function and increased TVR but no change in MAP. TVR may be a useful tool in the classification and management of FGR. The findings suggest that in FGR, there is increased blood viscosity due to lack of intravascular space expansion.