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. 2018 Jan 17:2018:1496903.
doi: 10.1155/2018/1496903. eCollection 2018.

Behaviour of the Foramen Ovale Flow in Fetuses with Intrauterine Growth Restriction

Ângela R L Nader  1 , Paulo Zielinsky  1   2 , Alexandre Antonio Naujorks  1 , Luiz Henrique S Nicoloso  1 , Antonio Luiz Piccoli Junior  1 , Natássia Miranda Sulis  1 , Luiza Ferreira van der Sand  1 , Victoria de Bittencourt Antunes  1 , Gabriela Dos Santos Marinho  1 , Fernanda Greinert Dos Santos  1 , Natan Pereira Gosmann  3 , Eduardo Becker Júnior  1 , Renato Frajndlich  1 , Tamara Beherens  1 , Marcelo Brandão da Silva  1 , Carolina Barbisan  1 , Stefano Busato  1 , Mauro Lopes  1 , Caroline Klein  1
Affiliations

Behaviour of the Foramen Ovale Flow in Fetuses with Intrauterine Growth Restriction

Ângela R L Nader et al. Obstet Gynecol Int. .

Erratum in

  • Corrigendum to "Behaviour of the Foramen Ovale Flow in Fetuses with Intrauterine Growth Restriction".
    Nader ÂRL, Zielinsky P, Naujorks AA, Nicoloso LHS, Piccoli Junior AL, Sulis NM, van der Sand LF, Antunes VB, Marinho GDS, Dos Santos FG, Gosmann NP, Becker Júnior E, Frajndlich R, Beherens T, da Silva MB, Barbisan C, Busato S, Lopes M, Klein C. Nader ÂRL, et al. Obstet Gynecol Int. 2018 Jul 22;2018:3725843. doi: 10.1155/2018/3725843. eCollection 2018. Obstet Gynecol Int. 2018. PMID: 30140285 Free PMC article.

Abstract

Background: Foramen ovale (FO) flow may be altered in IUGR. This study was designed to test this hypothesis.

Methods: Forty pregnant women (24-38 weeks) were divided into 3 groups: group I (IUGR), group II (adequate growth and maternal hypertension), and group III (normal controls). Impedance across the FO was assessed by the FO pulsatility index (FOPI): (systolic velocity - presystolic velocity)/mean velocity. Statistical analysis utilized ANOVA, Tukey test, and ROC curves.

Results: Mean FOPI in IUGR fetuses (n = 15) was 3.70 ± 0.99 (3.15-4.26); in the group II (n = 12), it was 2.84 ± 0.69 (2.40-3.28), and in the group III (n = 13), it was 2.77 ± 0.44 (2.50-3.04) (p=0.004). FOPI and UtA RI were correlated (r = 0.375, p=0.017), as well as FOPI and UA RI (r = 0.356, p=0.024) and, inversely, FOPI and MCA RI (r = -0.359, p=0.023).

Conclusions: The FO flow pulsatility index is increased in fetuses with IUGR, probably as a result of impaired left ventricular diastolic function.

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Figures

Figure 1
Figure 1
Foramen ovale flow and pulsatility index assessment: echocardiography of fetus at 33 weeks with intrauterine growth restriction. The foramen ovale pulsatility index is 3.70.
Figure 2
Figure 2
Mean of foramen ovale pulsatility index and p value for ANOVA between study groups. IUGR = intrauterine growth restriction; AGA = adequate for gestational age; MH = maternal hypertension.
Figure 3
Figure 3
Pearson correlation of the foramen ovale pulsatility index with resistance index of umbilical, median cerebral, and uterine arteries. MC = median cerebral.
Figure 4
Figure 4
Bland–Altman plots showing intraobserver (a) and interobserver (b) variation in measurements of the foramen ovale pulsatility index. CI = confidence interval; SD = standard deviation.
See this image and copyright information in PMC

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