Available online 23 May 2023

To assess differences in cardiac morphology and function at mid-gestation in fetuses from pregnancies that subsequently developed pre-eclampsia (PE) or gestational hypertension (GH).

This was a prospective study in 5801 women with singleton pregnancies attending for a routine ultrasound examination at mid-gestation, including 179 (3.1%) who subsequently developed PE and 149 (2.6%) who developed GH. Conventional and more advanced echocardiographic modalities, such as speckle tracking, were used to assess fetal cardiac function in the right and left ventricle. The morphology of the fetal heart was assessed by calculating the right and left sphericity index.

In fetuses from the PE group (vs. the no PE or GH group) there was a significantly higher left ventricular global longitudinal strain and lower left ventricular ejection fraction which could not be accounted for by fetal size. All other indices of fetal cardiac morphology and function were comparable between groups. There was no significant correlation between fetal cardiac indices and uterine artery pulsatility index (UtA-PI) multiple of the median (MoM) or placental growth factor (PlGF) MoM.

At mid-gestation, fetuses of mothers at risk of developing PE, but not those at risk of GH, have mild reduction in left ventricular myocardial function. Although absolute differences were minimal and most likely not clinically relevant, these may suggest an early programming effect on left ventricular contractility in fetuses of mothers who develop PE.

2023 Published by Elsevier Inc. on behalf of the American Society of Echocardiography.