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.

Objective: To analyze the ultrasonography (USG) values of median nerve cross sectional area (MN-CSA) in pregnant women with and without clinically diagnosed carpal tunnel syndrome (CTS). Design: Prospective cross-sectional study. Setting: Third trimester pregnant women during their routine office visits. Methods: USG was performed by a perinatologist and the MN-CSA at the carpal tunnel inlet was measured. Then, the participants were asked about the presence of typical CTS symptoms. Participants with typical clinical symptoms were assigned to the CTS group. Remaining participants were assigned to the Control group. Main outcome measures: The groups were compared according to MN-CSA. Results: Of the 89 pregnant women, 25 participants were grouped in CTS group and the remaining 64 participants were grouped in Control group. The MN-CSA was higher in the CTS group (9.44 ± 2.68) than in the Control group (7.20 ± 1.99), p = 0.00004. There was a statistically significant linear trend, p = 0.003, with higher MN-CSA associated with a higher proportion of patients diagnosed as CTS. Conclusions: USG measurement of MN-CSA at the wrist appears as a convenient method to confirm CTS diagnosis in pregnant women. Further research is necessary to determine a clear cut-off value for MN-CSA. Obstetricians can measure MN-CSA to confirm CTS diagnosis and consequently can offer conservative management, which is the widely accepted treatment modality in this cohort.

Objective: To evaluate both short and mid-term effects of maternal COVID-19 on cardiac functions of fetuses and children. Methods: The present case-control study was conducted on 36 pregnant women who had COVID-19 infection in the second trimester of pregnancy and 30 pregnant women as healthy controls. Fetal, neonatal and infant cardiac functions were compared between the groups. Assessment of fetal cardiac functions were performed in the last trimester of the pregnancy at least 6 weeks after the recovery of infection. The first postnatal echo was performed within the first two weeks and the follow-up (second) echo was performed in the 6-8 weeks of life. Results: The demografic data were similar between groups. Interventricular septum and left ventricular posterior wall end-diastolic dimensions were significantly higher in the study group in both fetal, neonatal and infant periods. Impaired diastolic functions of right and left ventricles were detected and myocardial performance indexes with tissue doppler imaging of both lateral walls and septum were significantly higher than controls at all periods. Conclusion: Maternal COVID-19 seems to have a global impact on cardiac functions of babies in the short and mid-term periods after maternal recovery.

Aim:This study aims to investigate the effects of maternal asthma on fetal cardiac functions. Methods:The study was planned with 30 pregnant women who presented to a tertiary health center and were diagnosed with asthma and 60 healthy controls with similar gestational ages. The fetal echocardiographic assessment was assessed between 33 and 35 weeks of gestation with pulsed-wave Doppler (PW), M-mode, and tissue Doppler imaging (TDI). Fetal cardiac functions were compared between maternal asthma and control group. Cardiac functions were assessed according to the duration of maternal asthma diagnosis, as well. Results:Early diastolic function parameters, tricuspid E wave (p=0.001), and tricuspid E/A ratio (P=0.005) were significantly lower in the group with maternal asthma. TAPSE and MAPSE values were statistically lower in the study group than in the control group; p=0.010 and p=0.012, respectively. Parameters assessed with TDI (E’, A’, S’, E/E’, and MPI’ of tricuspid valves) and global cardiac function parameters assessed with pulsed-wave Doppler like myocardial performance index (MPI) and left cardiac output (LCO) were similar between groups (p> 0.05). Although, MPI did not change between groups, and the isovolumetric relaxation time (IVRT) value was prolonged in maternal asthma cases (p=0.025). Conclusion:We found that maternal asthma disease causes alteration in fetal diastolic and early systolic cardiac functions, but the global fetal cardiac function does not change. Diastolic heart function values also varied with the duration of maternal asthma. Prospective studies are needed to compare fetal cardiac functions with additional patient groups according to disease severity and type of medical treatment.

Aim: We aimed to examine fetal cardiac output (CO) in patients who recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Materials: This prospective study included 48 pregnant women recovered from SARS-CoV-2 infection and 50 control cases. SARS-CoV-2 infection was diagnosed by polymerase chain reaction (PCR) test in patients. Fetal echocardiographic evaluations were performed at 24-37 weeks of gestation in pregnant women who recovered from the infection and control group. Results: The median value of ultrasound evaluation was 34 (2.6) weeks of gestation in the recovery from the SARS-CoV-2 infection (RSI) group, and 32 (7.6) weeks in the control group (p=0.565). Left cardiac output (LCO) z score was significantly lower in the RSI group than the control group (p=0,041). LCO and combine cardiac output (CCO) z score were significantly lower in the severe disease group than mild, moderate disease groups, and controls (p=0,019 and p=0,013). CCO (mL/min/kg) was decreased in the severe disease group when compared with control and mild disease groups (p=0,044). Fetal distress, preterm delivery rate, and neonatal intensive care unit (NICU) admission were found to be higher in the severe disease group compared to the control group (p=0,010, p=0,009, and p<0,001 respectively). Conclusion: In the present study, fetal cardiac output in pregnant women with recovery from SARS-CoV-2 infection was found significantly decreased, especially in whom had severe diseases. Placental dysfunction and inflammatory cytokines might cause fetal cardiac changes. Further studies could be clarified on the impact of SARS-CoV-2 infection on fetal cardiac function.