Parameters indicating impaired frontal lobe development in the second trimester in fetuses with congenital heart disease.

OBJECTIVE

This study investigates differences in frontal lobe development and fetal biometries in second-trimester fetuses with different phenotypes of congenital heart disease (CHD) and analyzes correlations between parameters.

METHODS

A total of 137 fetuses of gestational age between 20 and 28 weeks diagnosed with CHD by ultrasound between 2017 and 2023 were retrospectively selected as the CHD group and divided into left-sided obstructive lesion (LSOL) and right-sided obstructive lesion (RSOL) groups according to the blood and/or oxygen supply to the brain. Normal fetuses matched for gestational age were selected as a control group. The frontal lobe anteroposterior diameter (FAPD) and occipitofrontal diameter (OFD) were measured and several fetal biometries were retrieved. After 1:1:1 propensity score matching across each group, each parameter was evaluated for between-group differences.

RESULTS

Compared with the normal control group, the CHD group had significantly smaller FAPD, with the LSOL group having the smallest FAPD. Compared with the RSOL and normal control groups, the LSOL group had significantly lower FAPD/OFD ratio, MCA-PI, and CPR but higher UA-PI and average UtA-PI. In the CHD group, FAPD was positively correlated with MCA-PI and CPR and negatively correlated with UA-PI and average UtA-PI.

CONCLUSION

Fetal frontal lobe development was impaired in second-trimester fetuses with CHD, with this impairment being more obvious in the LSOL group than in the RSOL group. Changes in cerebral perfusion and placental insufficiency in second-trimester fetuses with CHD might be related to impaired frontal lobe development.