Abstract
Background: Prolonged pregnancy is associated with high
incidence of perinatal morbidity and mortality. Understanding
the mechanisms that lead to oligohydramnios and abnormal
fetal heart rate pattern may prove to be useful for diagnosis,
follow-up and management. Little information exists regarding
fetal cardiac function in prolonged pregnancy.
Aim of the Work: The aim of our study was to evaluate
the hypothesis that prolonged pregnancy is associated with
deterioration of fetal cardiac performance.
Patients and Methods: This is a cross-sectional study
included ninety five pregnant ladies uncomplicated, singleton
pregnancy. Fifty two ladies were at term (37-40 weeks) and
43 were more than 41 weeks. Abdominal ultrasound was done
to assess amount of amniotic fluid and gestational age.
Doppler study of fetal umbilical artery was done to exclude
cases with abnormal placental blood flow. Fetal
echocardiography studies were performed using Doppler and
M-mode sonography. Left ventricular dimensions, systolic
and diastolic functions, stroke volume as well as cardiac
output were assessed. Fetal heart rate pattern and amniotic
fluid index were recorded.
Results: Prolonged pregnancy is associated with reduced
fetal cardiac output by using both Doppler and M-mode fetal
echocardiography techniques. Deteriorated Left ventricular
diastolic compliance and systolic ejection were correlated
significantly with oligohydramnios and abnormal fetal heart
rate pattern.
Conclusion: These findings suggested that fetal cardiac
function is impaired in prolonged pregnancy that might play
a role in increased perinatal morbidity and mortality in pro-
longed pregnancy.
Key Words: Prolonged pregnancy – Fetal echocardiography
– Cardiac output.