[Diagnosis of placental insufficiency in patients with acquired heart defects].

The feto-placental unit has been evaluated in 102 patients with acquired heart disease presenting as different circulatory states (Grade 0 insufficiency in 43, Grade I in 34 and Grade II A-B in 25 women). Placental scintigraphy was performed in 102, cardiotocography in 77, ultrasonographic fetal and placental biometry in 102 and placental pathological examination in 15 women. The neonatal study included 104 infants, with 2 twin pairs. Scintigraphy revealed utero-placental blood flow (UPBF) impairment in 72 (70.6%) pregnancies; cardiotocography showed chronic fetal hypoxia in 51 (66.1%) and ultrasonography showed intrauterine growth retardation in 44 (43.1%) pregnancies. Disorders of UPBF coexisted with chronic fetal hypoxia and intrauterine growth retardation in 33 (42.8%) pregnancies, with chronic fetal hypoxia in 18 (23.4%) pregnancies. Impairment of UPBF alone was seen in 13 (16.9%) pregnancies. The digoxin test was done concomitantly with placental scintigraphy in 28 patients; it improved diagnostic precision and provided a measure of compensation of impaired UPBF.