Congenital Heart Disease Fetuses Have Decreased Mid-Gestational Placental Flow, Placental Malperfusion Defects, and Impaired Growth

Placental health may impact the development and outcomes of congenital heart disease (CHD). CHD fetuses have been shown retrospectively to have decreased placental blood flow. The purpose of this study was to determine if CHD fetuses with decreased placental blood flow have placental pathology at birth and if there is a relationship between placental blood flow, placental pathology, and outcomes. We performed a prospective case-control study of 38 CHD fetuses, including 28 with single ventricle physiology and 36 controls. Demographic, clinical, and postnatal biometric data were collected. Umbilical venous volume flow (UVVF) was measured from 2nd trimester fetal echocardiograms. Placentas underwent standardized pathological analysis. Standard descriptive statistics and regression analyses were performed to analyze the relationship between UVVF, placental defects, and outcomes. CHD fetuses had a 15% decrease in mid-gestational UVVF indexed to fetal weight (P