Abstract
Background
Structural heart disease, influences cerebral size and maturity as early as in fetal life. Newborns with major heart disease often have visible lesions on cerebral MRI even before surgery and children with major heart disease have increased risk of neurodevelopmental problems. There are several reasons for this. We aim to explore if fetal cerebral oxygenation is affected in fetal heart disease.
Materials and Methods
In BOLD MRI, presence of deoxyhemoglobin darkens the signal. By using serial echo times in a breath-hold T2* (ms) can be calculated and is presumed a proxy for oxygenation in tissues. By performing serial T2* measurements (GA week 30-32 and GA week 36-38) in healthy pregnant women expecting a child with heart disease and in healthy controls expecting healthy singletons, we hope to illuminate:
- If fetal cerebral T2* is reduced in fetal heart disease?
- If maternal hyper oxygenation increases fetal cerebral T2*?
- If low fetal cerebral T2* is associated with neurodevelopmental problems at 18 and 36 months follow-up?
Preliminary Results
11 fetuses with heart disease and 20 normal fetuses
Cerebral T2* seems to decrease with increasing gestational age.
So far no difference in cerebral T2* between normal fetuses and fetuses with heart disease has been detected.
Conclusion
There are few and inhomogeneous fetuses with heart disease to include in the study.
Fetal cerebral T2*measurements are challenged by fetal movement and other artifacts.
The prognostic value of the cerebral T2* measurements has yet to be evaluated.
Study and analysis are ongoing.
Case story
Fetal heart disease. Cerebral T2* measurement GA 261 days was 77 ms. Spontaneous labor in GA 273 days (week 39+2). Pathological CTG. Cesarean section. Meconium-stained liquor. Apgar 1/1, 1/5. Needs resuscitation. Weight 3 kg, length 52 cm, Head circumference 37 cm. Has acute liver failure and develops right ventricular failure. Dies two weeks old.
Question
This child has several competing reasons for a low Apgar score and a poor outcome (Congenital heart disease, Meconium aspiration syndrome, Hypoxic ischemic encephalopathy and possibly liver disease) but could cerebral T2* measurements be of any value in predicting outcome? We are still looking into this question.
Structural heart disease, influences cerebral size and maturity as early as in fetal life. Newborns with major heart disease often have visible lesions on cerebral MRI even before surgery and children with major heart disease have increased risk of neurodevelopmental problems. There are several reasons for this. We aim to explore if fetal cerebral oxygenation is affected in fetal heart disease.
Materials and Methods
In BOLD MRI, presence of deoxyhemoglobin darkens the signal. By using serial echo times in a breath-hold T2* (ms) can be calculated and is presumed a proxy for oxygenation in tissues. By performing serial T2* measurements (GA week 30-32 and GA week 36-38) in healthy pregnant women expecting a child with heart disease and in healthy controls expecting healthy singletons, we hope to illuminate:
- If fetal cerebral T2* is reduced in fetal heart disease?
- If maternal hyper oxygenation increases fetal cerebral T2*?
- If low fetal cerebral T2* is associated with neurodevelopmental problems at 18 and 36 months follow-up?
Preliminary Results
11 fetuses with heart disease and 20 normal fetuses
Cerebral T2* seems to decrease with increasing gestational age.
So far no difference in cerebral T2* between normal fetuses and fetuses with heart disease has been detected.
Conclusion
There are few and inhomogeneous fetuses with heart disease to include in the study.
Fetal cerebral T2*measurements are challenged by fetal movement and other artifacts.
The prognostic value of the cerebral T2* measurements has yet to be evaluated.
Study and analysis are ongoing.
Case story
Fetal heart disease. Cerebral T2* measurement GA 261 days was 77 ms. Spontaneous labor in GA 273 days (week 39+2). Pathological CTG. Cesarean section. Meconium-stained liquor. Apgar 1/1, 1/5. Needs resuscitation. Weight 3 kg, length 52 cm, Head circumference 37 cm. Has acute liver failure and develops right ventricular failure. Dies two weeks old.
Question
This child has several competing reasons for a low Apgar score and a poor outcome (Congenital heart disease, Meconium aspiration syndrome, Hypoxic ischemic encephalopathy and possibly liver disease) but could cerebral T2* measurements be of any value in predicting outcome? We are still looking into this question.
| Original language | English |
|---|---|
| Publication date | 22 Jan 2016 |
| Publication status | Published - 22 Jan 2016 |
| Event | PhD Day 2016 - Aarhus Universitet, Aarhus , Denmark Duration: 22 Jan 2016 → 22 Jan 2016 |
Conference
| Conference | PhD Day 2016 |
|---|---|
| Location | Aarhus Universitet |
| Country/Territory | Denmark |
| City | Aarhus |
| Period | 22/01/2016 → 22/01/2016 |