Aspectos morfológicos e tomográficos de corações fetais necropsiados

Abstract

Introduction: Studies on fetal cardiac development are scarce and utilize various techniques to measure the ventricles, but without correlating these measurements with gestational development through stratification based on gender, gestational age, and fetal weight. Aim: To evaluate the thickness of the left and right ventricles and the interventricular septum using a digital caliper and computed tomography (CT) in hearts obtained during autopsies, and to associate these measurements with gestational age, sex, and weight. Methods: 40 hearts from stillborn infants autopsied at the Hospital of the Federal University of Triângulo Mineiro (HC/UFTM), were analyzed. The thickness of the ventricular free walls and interventricular septum was measured using a digital caliper and computed tomography. The quantification of collagen fibers was performed using computerized morphometry. Results: The majority of the evaluated hearts were from female fetuses (55%), with an average gestational age of 31.89 weeks and a mean body weight of 1.81 kg. Regarding the measurement techniques for cardiac walls, computed tomography showed a strong correlation with digital caliper measurements (r=0.9208, p<0.0001). In terms of measurements, the right ventricles presented greater thickness compared to the left ventricle and interventricular septum, both in digital caliper and CT measurements. The behavior of the measurements remained similar even when stratifying the hearts by sex, gestational age, and body weight. Conclusion: CT presents itself as na evaluation tool for the cardiac morphology of fetuses, enabling reliable measurements and quantitative evaluation of the thickness of the cardiac walls to be carried out, and that such measurements can help in the evaluation of cardiac development with less invasiveness of post-mortem investigation. This study is at the forefront of research into the morphological alterations of the heart in stillborn fetuses. In view of this , we find limitations to the comparsion of the results of this study whith the literature.