Neurodevelopment and Fetal Growth in Fetuses with Congenital Heart Disease

Abstract

Objective: To determine mechanisms underlying fetal growth abnormalities, particularly intrauterine neurodevelopment, in congenital heart defects. Method: Literature Review. Results: Since intrauterine, smart mechanisms have ensured that blood flow to the central nervous system remains smooth to maintain Neurodevelopment. The mechanism fluctuates to keep oxygen flowing to the brain. Blood with the highest oxygen content should always be pumped to upper body and the head via the heart and the aorta. Aortic arch region contains three major blood vessels, a.Brachiocephalic, a.Carotid communis, and a.Subclavia that bleed the upper body and head, including the brain. So, blood flow from the left heart through the aortic arch is critical for fetal brain growth. If the heart cannot drain blood to the head, brain growth will be jeopardized because hypoxia will interfere with brain growth so will be influence to Neurodevelopment. Impaired blood flow can occur as early as intrauterine, particularly if the fetus has congenital heart disease. Blood flow in the Middle Cerebral Artery (MCA) can be used to measure blood flow in the fetus head. The pulsatility index value can be used to measure blood flow in the MCA, and another parameter is the cardioplacental ratio. There is a decrease in flow to the head in congenital heart disease, which results in a decrease in the Pulsatily index of the MCA and a decrease in the cardioplacental ratio. Conclusions: Prolonged reduction in cardiac-derived blood flow leads to compromised neurodevelopment. Consequently, timely correction of postpartum heart defects becomes paramount to prevent protracted impairments in brain growth. Failing to address this promptly could also diminish the overall quality of life for children afflicted by congenital heart disease.