Maternal-fetal link possible with fetal growth restriction and preeclampsia

  • Am J Obstet Gynecol

  • curated by Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • Maternal cardiovascular dysfunction may play a role in fetal growth restriction (FGR) and preeclampsia (PE).

Why this matters

  • Early-onset PE and FGR are associated with abnormal maternal cardiac function (low cardiac output and high vascular resistance).
  • These authors suggest 2 pathways to PE depending on the presence or absence of FGR.
  • They suggest that maternal cardiovascular dysfunction precedes FGR and PE rather than being initiated by placental maldevelopment, the current theory.
  • Assessment of maternal cardiovascular function may be an important adjunctive modality in determining fetal health and in surveillance of pregnancies at risk for PE and FGR.

Key results

  • There is a relationship between maternal cardiovascular function and uterine and fetal Doppler indices.
  • Mean uterine pulsatility index was higher in FGR (1.37) and PE+FGR (1.63) but not PE alone (0.92) when compared with controls (0.8) (P<.001>

Study design

  • Prospective cohort study between 2015 and 2017.
  • Women were stratified into 4 groups: FGR alone (n=17), PE alone (n=13), FGR+PE (n=15), and controls (n=62).
  • All women underwent serial ultrasound scans for fetal biometry and Doppler velocimetry.
  • Funding: None.  

Limitations

  • Small numbers in study.

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