Hemodynamic abnormalities in fetuses with congenital heart disease

The purpose of this investigation was to assess left and right ventricular function, volume ejection fi-action, combined stroke volume, and combined v entricular output in the human fetus with congenital heart disease compared to the normal healthy fetus. Seventy-two fetuses with a variety of in uter o diagnosed congenital cardiac defects were compared with a control group o f fetuses with structurally normal hearts matched for race, maternal age, a nd gestational age. We demonstrated significant hemodynamic changes in the fetus with congenital heart disease. There was a significant (p < 0.0001) d ecrease in the volume ejection fractions, biventricular stroke volume, and cardiac output in the congenital heart disease group compared to matched co ntrols. Our findings suggest that hemodynamic abnormalities in the fetus wi th congenital heart disease are present before birth and we speculate that myocardial reserve may not be adequate to respond to hemodynamic stressors such as birth or heart surgery.