Fetal inflammatory response syndrome (FIRS): cardiovascular adaptation
DOI:
https://doi.org/10.18597/rcog.240Keywords:
FIRS, ventricular dysfunction, intraamniotic infectionAbstract
Introduction: fetal inflammatory response is a condition which is characterized by systemic inflammatory reaction accompanied by biochemical alterations such as raised interleukin 6 (IL-6) levels. It was first described over a decade ago and emerged from the need to understand fetal behavior in many known clinical situations. The purpose of this review was to provide the reader with the basis for understanding the entity and thus improve early diagnosis.
Materials and methods: a review of the pertinent literature from 2000 to 2009 was made by searching MEDLINE databases via PubMed, EBSCO, Ovid and ProQuest. Review articles and original research were included.
Results: fetuses having premature rupture of membranes (PROM) present alterations in passive ventricular filling (E) and atrial contraction (A). Such relationship is clinically evaluated by using the E/A formula and the myocardial performance index which is applicable in both ventricles. Changes in morphological characteristics regarding waves in Doppler evaluation in fetuses suffering PROM suggest high distensibility of the left ventricle, especially in fetuses exposed to intraamniotic infection. Fetuses which do not manage to change cardiac distensibility may not maintain stroke volume and thus may not achieve suitable cerebral perfusion, thereby creating an ideal microenvironment for alterations to develop in the central nervous system.
Conclusion: microbial infection and invasion of the amniotic cavity are associated with changes in fetal cardiovascular function, this being mainly consistent with increased ventricular distensibility.
Author Biographies
Mortimer Arreaza-Graterol
Juan Diego Rojas-Barrera
Saulo Molina-Giraldo
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