{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T20:14:09Z","timestamp":1792613649624,"version":"4.5.0"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the effects of maternal hyperoxygenation (MH) on fetal hemodynamic parameters assessed by ultrasound and fetal echocardiography in pregnancies complicated by congenital heart disease (CHD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review and single\u2010arm meta\u2010analysis were conducted according to PRISMA guidelines and registered in PROSPERO (CRD420251274436). PubMed, EMBASE, and Cochrane Central were searched for studies evaluating fetal hemodynamic changes before and during MH in fetuses with prenatally diagnosed CHD. Continuous outcomes were pooled as mean changes using inverse\u2010variance random\u2010effects models. Risk of bias was assessed with ROBINS\u2010I and Joanna Briggs Institute tools, and the certainty of evidence was graded using GRADE. Middle cerebral artery Z\u2010score (MCA\u2010Z) was defined as the standardized deviation of the Doppler pulsatility index from gestational age\u2013adjusted reference values. Pulmonary velocity time integral (VTI) was measured by Doppler at the level of the fetal pulmonary artery to estimate pulmonary flow.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, MH was associated with reduced MCA\u2010Z score and increased pulmonary VTI, indicating cerebral circulatory adaptation and augmented pulmonary flow parameters among the nine observational studies included. Substantial heterogeneity was observed, mainly related to study design, confounding, and variability in MH protocols and Doppler methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In fetuses with CHD, MH is associated with consistent cerebral Doppler changes and selected pulmonary flow adaptations. These findings support MH primarily as a physiological assessment tool rather than a routine therapeutic intervention. Further standardized studies are needed to clarify its clinical relevance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pd.70143","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T13:55:18Z","timestamp":1775483718000},"page":"1037-1046","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of Maternal Hyperoxygenation on Fetal Hemodynamics Assessed by Ultrasound and Fetal Echocardiography in Congenital Heart Disease: A Systematic Review and Single Arm Meta\u2010Analysis"],"prefix":"10.1002","volume":"46","author":[{"given":"Giovanna C. C.","family":"Martin","sequence":"first","affiliation":[{"name":"Department of Medicine Hospital Santa Marcelina  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9778-9624","authenticated-orcid":false,"given":"Maria J.","family":"Lemos","sequence":"additional","affiliation":[{"name":"Department of Medicine Redentor University Center  Itaperuna Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana C. P.","family":"Servidoni","sequence":"additional","affiliation":[{"name":"Department of Medicine Hospital Santa Marcelina  S\u00e3o Paulo Brazil"},{"name":"Obstetrics, Gynecology and Reproductive Science Department Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2286-3948","authenticated-orcid":false,"given":"Davi","family":"Barbosa","sequence":"additional","affiliation":[{"name":"Department of Medicine University Center of Macei\u00f3  Macei\u00f3 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme F.","family":"Machado","sequence":"additional","affiliation":[{"name":"Department of Medicine Hospital Santa Marcelina  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wellgner F. O.","family":"Amador","sequence":"additional","affiliation":[{"name":"Department of Medicine Universidade Federal de Campina Grande  Cajazeiras Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9162-5335","authenticated-orcid":false,"given":"Laura F.","family":"Queiroz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Santa Casa de Miseric\u00f3rdia of Belo Horizonte  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6323-2234","authenticated-orcid":false,"given":"Paulo V. Z.","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Obstetrics, Gynecology and Reproductive Science Department Faculdade de Medicina de Ribeir\u00e3o Preto da Universidade de S\u00e3o Paulo  Ribeir\u00e3o Preto Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3642-5858","authenticated-orcid":false,"given":"Rodrigo","family":"Ruano","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology University of Miami Miller School of Medicine, &amp; Jackson Memorial Hospital  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,6]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.22024"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2015.11.004"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7211168"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26240"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.15557\/JoU.2019.0043"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884\u2010021\u201004028\u20105"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.29097"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/children10020281"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.11124\/JBIES\u201022\u201000430"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102288\u201014\u2010135"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0962280216669183"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14688"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2022.03.015"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15846"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.27657"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000519322"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.109.848432"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2024.12.011"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2017.05.008"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.125.042014"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437597.44550.5d"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471\u20100528.2004.00273.x"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2023.04.014"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2005.10.029"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2004.04.011"}],"container-title":["Prenatal Diagnosis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pd.70143","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pd.70143","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pd.70143","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:24:09Z","timestamp":1791379449000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/pd.70143"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,6]]},"references-count":26,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/pd.70143"],"URL":"https:\/\/doi.org\/10.1002\/pd.70143","archive":["Portico"],"relation":{},"ISSN":["0197-3851","1097-0223"],"issn-type":[{"value":"0197-3851","type":"print"},{"value":"1097-0223","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,6]]},"assertion":[{"value":"2026-02-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}