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.