Evaluating fetal pulmonary vascular development in congenital heart disease: a comparative study using the McGoon index and multiple parameters of fetal echocardiography

Abstract Purpose: The purpose of this study was to evaluate the value of MGI and multiple parameters in the diagnosis of congenital heart disease with different pulmonary circulation blood volumes. Methods: This study included 349 fetuses categorized into three groups: Group A consisted of 258 fetuses with no discernible abnormalities identified through echocardiography; Group B included 71 fetuses with decreased pulmonary blood flow or pulmonary atresia; and Group C comprised 20 fetuses with reduced or detached aortic flow. The MGI and Z-scores were measured and compared among these groups. Results: Significant variations were noted in the aortic outflow Z-scores (AO-Zs), pulmonary artery (PA), PA Z-scores (PA-Zs), PA/AO, right PA , and MGI among the three groups (all p < 0.05). Among fetuses with decreased pulmonary blood flow or pulmonary atresia, PA, PA-Zs, and MGI in fetuses with reverse DA flow perfusion were lower than those in the DA forward perfusion group. Conclusion: Fetal echocardiography, incorporating the MGI and multiple parameters, not only allows for the evaluation of pulmonary blood flow and pulmonary vascular development of the fetus but also enables the observation of changes in pulmonary blood flow and MGI development across different gestational weeks.