Fetal Cardiac Functions and Remodeling in In Vitro Fertilization
Pregnancies: A Tertiary Center Experience
Abstract
Purpose: To investigate fetal cardiac functions and remodeling
in pregnancies conceived via in vitro fertilization (IVF).
Methods: This prospective case-control study included 40
singleton IVF pregnancies and 46 uncomplicated control pregnancies at
28–36 weeks of gestation. The IVF group consisted of pregnancies
admitted to the hospital, excluding those with anatomical or chromosomal
abnormalities. Fetal cardiac morphological measurements, left myocardial
performance index, cardiac output, spectral, tissue Doppler, and M-mode
measurements were recorded. Ventricular and great vessel size were
assessed for fetal cardiac morphology, while myocardial performance
index, spectral Doppler and tissue Doppler parameters were assessed for
cardiac function. Results: Cardiothoracic circumference ratio
and both ventricular areas were found to be significantly smaller in the
IVF group than in the control group. The right ventricular basal
sphericity index was also smaller in the IVF group. The mitral and
aortic valves were smaller in the IVF group, while tricuspid and
pulmonary valve measurements were similar. Left ventricular ejection
time was statistically lower in the IVF group, although the myocardial
performance index was similar. The IVF group had higher right fetal
myocardial performance index on tissue Doppler imaging and lower cardiac
output than the control group, but the difference was not statistically
significant. Conclusion: This study demonstrated the presence
of cardiac morphological remodeling and mild systolic dysfunction in IVF
pregnancies.