OBJECTIVE: This study was designed to evaluate if fetal diastolic cardiac function is compromised in small-for-gestational-age (SGA) fetuses with documented fetal well-being at the biophysical profile. STUDY DESIGN: We have compared indices of diastolic cardiac flow in singleton SGA fetuses with forward diastolic flow in the umbilical artery at Doppler velocimetry and documented fetal well-being (n = 10) with those of appropriate-for-gestational-age (AGA) controls with documented fetal well-being matched for gestational age at ultrasound (n = 20). RESULTS: At the mitral valve, velocity time integral (VTI) (0.059+/-0.011 vs. 0.069+/-0.011 m, p = 0.04), peak velocity of the A wave (0.426+/-0.043 vs. 0.498+/-0.087 m/s, p = 0.005), and acceleration time of the E wave (0.046+/-0.004 vs. 0.053+/-0.007 s, p = 0.008) were significantly different between SGA and AGA fetuses. At the right atrioventricular valve, only VTI was significantly different between SGA and AGA fetuses (0.065+/-0.014 vs. 0.078+/-0.011, p = 0.03). CONCLUSIONS: These findings suggest that SGA fetuses have significantly lower left and right ventricular diastolic filling compared with AGA fetuses without significant changes in diastolic function.

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