ASSESSMENT OF FETAL CARDIAC FUNCTION: IMPLICATIONS FOR PAKISTAN

Abstract

The heart is a key organ in the fetal development since it is responsible for perfusion and proper development of all fetal organs. From the very early stages of pregnancy, heart must maintain adequate cardiac output in a continued manner and be able to adapt to changing circulatory demands. Certain pathologies in fetal life can affect the proper functioning of the cardiovascular system and can even cause heart failure, hydrops and fetal death. Fetal echocardiography is one such tool, which can assess the status of the heart, both structural and functional.In Pakistan, fetal echocardiography has been in service for over a decade, primarily to identify fetuses with structural malformations of the heart and is now a part of routine fetal surveillance. However, evaluation of fetal cardiac function using echocardiography has received minimal attention and its utilization in functional assessment of the fetal heart and circulation is still awaited. Recently, research efforts have recognized the potential value of fetal cardiac function for clinical management. Given the substantial evidence indicating the occurrence of programming of adult cardiovascular disease in fetal life, it is logical to state that the integration of functional fetal echocardiography into clinical practice in developing country like Pakistan will be useful to detect and monitor not only fetuses at-risk of cardiac failure or cardiac dysfunction but also to help predict perinatal and long term cardiovascular outcomes.