Background: The aim of the study was to analyze the neonatal outcomes of fetuses with diagnosed functional cardiovascular abnormalities, also considering the connection with neonatal hyperbilirubinemia. Materials and Methods: It was an observational study of 100 neonates who had fetal echocardiography examinations in the third trimester (mean gestational age during the last echocardiography was 34 ± 3 weeks and mean birth weight was 3550 g). There were two groups: A: normal heart anatomy + no functional anomalies; group B: normal heart anatomy + functional abnormalities. Hyperbilirubinemia was defined as a bilirubin level of >10 mg%. Results: In group A, there were 72 cases and only 5 cases despite having normal heart anatomy and normal heart study that presented additional problems. In group B (28 cases), the prenatal functional findings included tricuspid regurgitation (TR) (15 cases, 53%), pericardial effusion (4 cases, 14%), myocardial hypertrophy (4 cases, 14%), cardiomegaly (2 cases, 7%), abnormal bidirectional blood flow across the foramen ovale (3 cases, 11%), aneurysm of atrial septum (2 case, 7%), abnormal E/A ratio for mitral and tricuspid valve (1 case, 3%), bright spot (3 case, 11%), abnormal Doppler flow in ductus arteriosus compared to aortic arch (difference >60 cm/s) (1 case, 3%), supraventricular tachycardia (SVT) (1 case), and mitral regurgitation (1 case, 3%). In group A (n = 72 cases), bilirubin levels of >10 mg/dL were observed in 8% of newborns. In group B (n = 28), bilirubin levels of > 10 m/dL were observed in 46% of cases and TR was present in group B in 53% of cases (15/28 cases). The difference between group A and B in terms of elevated bilirubin levels was statistically significant (p < 0.001). Conclusions: In the case of fetal normal heart anatomy and normal heart study, a good neonatal outcome may be expected. When fetal cardiovascular functional abnormalities in normal heart anatomy are detected, with special attention paid to tricuspid valve regurgitation, a neonatal elevated bilirubin level (mean 11 mg/dL, range 10–15 mg/dL) may be expected.

The echocardiographic monitoring of a fetus with multiple nuchal cords around the fetal neck is important as it may result in cardiac remodeling and preferential streaming, thus affecting the condition of the fetus. The main aim of our study was to assess whether the collision of the umbilical cord around the fetal neck can lead to discrepancies in the size of the pulmonary artery and the aorta in the three-vessel view and to an increase in the size of the heart, which may result from the compression of the carotid arteries caused by the umbilical cord wrapping around the fetal neck. A total number of 854 patients were included in this study and divided into three groups. Group A (control group) included 716 fetuses (84%) without the umbilical cord around the fetal neck. Group B (study group B) included 102 fetuses (12%) with one coil of the umbilical cord around the fetal neck. Group C (study group C) included 32 fetuses (4%) with two coils of the umbilical cord around the fetal neck. The range of the gestational age of the patients considered for this study was 27–40.2 weeks based on the ultrasound biometry and was not statistically different between the analyzed groups A, B and C (p > 0.05). The Pa/Ao index was calculated by dividing the value of the width of the pulmonary artery (in mm) to the width of the aorta (in mm) measured in the ultrasound three-vessel view. We found that fetuses that the fetuses with one and two coils of the umbilical cord around the neck showed significantly higher values of the width of the pulmonary trunk with the unchanged value of the aorta width. Therefore, we also observed significantly higher values of the ratio of the pulmonary trunk to the aorta for the fetuses wrapped with the umbilical cord around the neck compared with the control group without the umbilical cord around the neck (. Moreover, in the fetuses with one and two coils of the umbilical cord around the fetal neck, an increased amount of amniotic fluid was observed, whereas larger dimensions of CTAR in the fetuses with two coils of the umbilical cord around the neck were present (p < 0.05). The wrapping of the fetus with the umbilical cord around the fetal neck may induce the redistribution of blood flow, leading to fetal heart enlargement and disproportion and may be the cause of polyhydramnios.

Background/Objectives: The main goal of this study was to determine whether ductal constriction in the third trimester of a pregnancy during fetal echocardiography examination has an impact on the neonatal clinical condition during the first days after birth. Methods: A retrospective study was based on 348 newborns who were examined during their fetal life in the third trimester of a pregnancy in our fetal cardiology center. They were divided into two groups: the study group (n = 49): neonates with “normal heart anatomy” (NHA), assessed by fetal echocardiography (ECHO) examination and prenatally diagnosed ductal constriction (NHA-DC); and the control group (n = 299): NHA neonates without DC (NHA-NDC). Results: Prenatally, DC was associated with other functional abnormalities, such as myocardial hypertrophy, cardiomegaly, tricuspid regurgitation, pericardial effusion and abnormal flow through foramen ovale. Neonates with prenatally diagnosed DC in 43% of cases presented with elevated neonatal bilirubin levels requiring phototherapy treatment (p < 0.006). In the study group 27% of neonates showed signs of breathing difficulties in the first hours of life (p < 0.001). Neonates with a prenatal diagnosis of DC were hospitalized longer than neonates with a normal heart study (NHS) (p < 0.001). Conclusions: Neonates with a prenatal diagnosis of ductal constriction are prone to having transient respiratory problems (up to 27%) and mild neonatal hyperbilirubinemia (in presented series up to 43%). Gestational diabetes can be associated with ductal constriction.

Background/Objectives: The aim of this study was to determine the prevalence of functional cardiovascular anomalies detected on fetal echocardiography in third-trimester large-for-gestational-age (LGA) fetuses, who were subsequently born as macrosomic newborns with a birth weight exceeding 4000 g. Methods: A retrospective study was conducted on 1002 fetuses examined during the third trimester at our fetal cardiology center between 2018 and 2024. All fetuses were classified as having “normal heart anatomy” (NHA). Statistical analysis was performed using Microsoft Excel 2024, Statistica 13.1, and EasyMedStat (version 3.37.1). A p-value of <0.05 was considered statistically significant. Results: The 1002 fetuses were divided into two groups. The study group (NHA-LGA) consisted of 167 fetuses born with a weight of >4000 g and the control group (NHA-AGA) was made up of 835 fetuses with a birth weight between 2500 and 4000 g. In the NHA-LGA group, 24 fetuses (14.4%) experienced ductal constriction (DC), while in the NHA-AGA group, it was 11 (1.3%) fetuses (p < 0.00001). Myocardial hypertrophy was observed in 30 fetuses (18.0%) in the NHA-LGA group versus 72 (8.6%) in the NHA-AGA group (p < 0.0003). Additionally, cardiomegaly was noted in 95 fetuses (11.4%) in the NHA-LGA group, compared to 37 (4.4%) in the NHA-AGA group (p < 0.0004). Conclusions: LGA fetuses with normal heart anatomy may present with functional cardiovascular anomalies, including ductal constriction, myocardial hypertrophy, and cardiomegaly. In our cohort, such anomalies were identified in up to 51% of cases. These findings suggest that targeted fetal echocardiographic screening in macrosomic fetuses could be clinically valuable, even in the absence of structural heart defects, and may aid in the early identification of functional cardiac alterations that could impact perinatal management.