{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T02:52:05Z","timestamp":1782442325473,"version":"3.54.5"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T00:00:00Z","timestamp":1559779200000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"University of Groningen Junior Scientific Masterclass grant"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Congenital heart disease (CHD) has been associated with reduced fetal head circumference (HC), although the underlying pathophysiology remains undetermined. We aimed to define trends in fetal growth and cerebroplacental Doppler flow, and to investigate their relationship, in fetuses with CHD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective study in two fetal medicine units in The Netherlands. We included all fetuses with CHD in whom Doppler flow patterns (middle cerebral artery (MCA) pulsatility index (PI), umbilical artery (UA) PI and cerebroplacental ratio (CPR)) and biometry (HC and abdominal circumference (AC)) had been measured serially after 19\u2009weeks' gestation between January 2010 and November 2016. Fetuses were categorized into three groups based on the expected cerebral arterial oxygen saturation of their particular type of CHD: normal; mild to moderately reduced; severely reduced. Trends over time in <jats:italic>Z<\/jats:italic>\u2010scores were analyzed using a linear mixed\u2010effects model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 181 fetuses fulfilled the inclusion criteria. Expected cerebral arterial oxygen saturation in CHD was classified as normal in 44 cases, mild to moderately reduced in 84 and severely reduced in 53. In the cohort overall, average trends over time were significant for both HC and AC <jats:italic>Z<\/jats:italic>\u2010scores. HC <jats:italic>Z<\/jats:italic>\u2010scores showed a tendency to decrease until 23\u2009weeks, then to increase until 33\u2009weeks, followed by another decrease in the late third trimester. AC <jats:italic>Z<\/jats:italic>\u2010scores increased progressively with advancing gestation. MCA\u2010PI and UA\u2010PI <jats:italic>Z<\/jats:italic>\u2010scores showed significant trends throughout pregnancy, but CPR <jats:italic>Z<\/jats:italic>\u2010scores did not. There were no associations between expected cerebral arterial oxygen saturation and fetal growth. Average trends in MCA\u2010PI <jats:italic>Z<\/jats:italic>\u2010scores were significantly different between the three subgroups, whereas those in UA\u2010PI <jats:italic>Z<\/jats:italic>\u2010scores and in CPR <jats:italic>Z<\/jats:italic>\u2010scores were similar between the subgroups. There was no significant association between MCA\u2010PI and HC <jats:italic>Z<\/jats:italic>\u2010scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Fetal biometry and Doppler flow patterns are within normal range in fetuses with CHD, but show trends over time. Head growth in fetuses with CHD is not associated with cerebral blood flow pattern or placental function and HC is not influenced by the cerebral arterial oxygen saturation. \u00a9 2018 The Authors. Ultrasound in Obstetrics &amp; Gynecology published by John Wiley &amp; Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.19102","type":"journal-article","created":{"date-parts":[[2018,5,29]],"date-time":"2018-05-29T06:44:10Z","timestamp":1527576250000},"page":"769-778","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Growth patterns and cerebroplacental hemodynamics in\u00a0fetuses with congenital heart disease"],"prefix":"10.1002","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9037-8653","authenticated-orcid":false,"given":"M. J.","family":"Mebius","sequence":"first","affiliation":[{"name":"University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology  Groningen The\u00a0Netherlands"},{"name":"University of Groningen, University Medical Center Groningen, Department of Obstetrics &amp; Gynecology  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5276-1475","authenticated-orcid":false,"given":"S. A. B.","family":"Clur","sequence":"additional","affiliation":[{"name":"Emma Children's Hospital, Academic Medical Center Amsterdam, Department of Pediatric Cardiology  Amsterdam The\u00a0Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. S.","family":"Vink","sequence":"additional","affiliation":[{"name":"Emma Children's Hospital, Academic Medical Center Amsterdam, Department of Pediatric Cardiology  Amsterdam The\u00a0Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Pajkrt","sequence":"additional","affiliation":[{"name":"Academic Medical Center Amsterdam, Department of Obstetrics, Prenatal Diagnosis  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. S.","family":"Kalteren","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology  Groningen The\u00a0Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. M. W.","family":"Kooi","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology  Groningen The\u00a0Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. F.","family":"Bos","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology  Groningen The\u00a0Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. J.","family":"du Marchie Sarvaas","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Center for Congenital Heart Diseases, Pediatric Cardiology  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1894-0626","authenticated-orcid":false,"given":"C. M.","family":"Bilardo","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen, Department of Obstetrics &amp; Gynecology  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15970"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14881"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14677"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13373"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12448"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2010.547961"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000330202"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2011.597900"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17324"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e318265ee8a"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.013051"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a008771"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2007.128777"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2016.65"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0028-1103152"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1785"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-002-0404-0"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2002.00756.x"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000439527"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14919"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11147"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7474"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1159\/000209203"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.05.045"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2001.00397.x"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpme.1990.18.3.165"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5315"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5225"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781444311822"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.113.001859"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15980"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcn099"},{"key":"e_1_2_6_35_1","volume-title":"Proceedings of the Statistical Computing Section ASA","author":"Stone CJ","year":"1985"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.865568"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-200111000-00003"},{"key":"e_1_2_6_38_1","first-page":"524","volume-title":"Neurology of the Newborn","author":"Volpe JJ.","year":"2008"}],"container-title":["Ultrasound in Obstetrics &amp; 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