Impact of Fetal Weight in Assessment of Fetal Cardiac Output in Three Cases of High Output Cardiac Failure

Introduction Many different Doppler-derived techniques have been proposed for overall assessment of cardiovascular well-being. In this report, 3 cases of high output cardiac failure were presented with the aim of evaluating the effect of fetal weight on fetal combined cardiac output (CCO). Patients Information The first and second cases were referred to Yas Hospital for the management of fetal anemia at 31and 29 weeks of gestation, respectively, and the third case had a large solid and vascular sacrococcygeal teratoma at 17 weeks. The fetal weight in the first case was less than 10 percentile, in the second case was in normal limit, and in the third one was above 90 percentile. Left ventricle, right ventricle, CCO, and weight-indexed CCO were assessed for both fetuses and all were above normal limit, indicating high output cardiac failure. Right to left cardiac output ratio also increased obviously. Conclusion The fetal growth restriction overestimates the weight-indexed CCO and the weight above 90 percentile underestimates it. In these conditions, CCO seems more precise in demonstrating the true burden on fetal heart in comparison with weight-indexed CCO.