Assessment Of Right Diastolic Function Of The Normal Fetus Of Middle-late Pregnancy With Pulse Wave Doppler Echocardiography

Objective: Pulse Wave Doppler echocardiography was used to measure the fetal venous spectrum in the middle-late pregnancy.The value of spectral morphology and blood flow parameters in the diagnosis of fetal right ventricular diastolic function was discussed by analyzing the relationship between the spectrum and blood flow parameters with gestational weeks.Methods: A total of 85 pregnant women who underwent fetal echocardiography in The Second Hospital of Dalian Medical University from November 2016 to December2017 were selected as the subjects.The age of the pregnant women was 21~39 years old,the average age was(26.7±5.3)years,and the gestational age was 20~40 weeks,the average age was(27.6±3.1)weeks,all of them were single pregnancies.The fetus was divided into 5 groups according to gestational age: the first group from 20 w to 24w(n = 15 cases),the second group from 24w+1d to 28w(n = 15 cases),the third group from 28w+1d to 32w(n = 20 cases),the fourth group from 32w+1d to 36w(n = 19cases),the fifth group from 36w+1d to 40w(n = 16 cases).Selection criteria for pregnant women: past physical health,non-smoking drinking and other unhealthy habits,pregnant women and their spouse there is no major disease history,surgical history and family history.Fetal do not have hypoxia,growth retardation and so on during pregnancy.Fetal biological measurements consistent with the actual gestational age,there is no congenital heart deformity and abnormalities.In the process of image acquisition and measuring the amount of pregnant women were agreed well with the situation,the United States GE company production Voluson E8 measurements of color Doppler ultrasound was measured and recorded the blood flow spectrum using Pulse Wave Spectral Doppler echocardiography for the blood flow spectrum of fetal ductus venosus,superior and inferior vena cava was recorded,and the ratio of E/A of the tricuspid valve was analyzed,then found the relationship between fetal right ventricular diastolic functions and those parameters.Results:1.Fetal superior、inferior vena and ductus venosus blood flow parameters S,D,a wave velocity increased with gestational age increases,was positively correlated(P<0.05);inferior vena cava blood flow spectrums were similar to superior.The wave of S,D was positive,a wave is reverse.2.Ductus venosus is different,in the whole cardiac cycle showed antegrade flow;ductus venosus blood flow parameter S/a was negatively correlated with gestational age.3.Blood flow spectrum of E wave of tricuspid valve with gestational age increase was positively correlated(P<0.05),A wave changes with gestational age between the obviously,E/ A increased with the increase of gestational age,but the ratio is always less than 1(P<0.05).4.Fetal superior、inferior and ductus venosus blood flow parameters D wave and tricuspid E/A ratio were positively correlated(P<0.05).Conclusions:1.Fetal superior、inferior vena cava and ductus venosus is main vein connected to the fetal right ventricle,the changes in the blood flow spectrum can response fetal right heart function,the use of Pulse Wave Doppler echocardiography to measure the normal Middle-late pregnancy fetal venous blood flow spectrum and found that the relationship between gestational age can further determine the fetus’ s right heart function.2.Fetal ductus venosus is one of the fetal blood vessels.Its blood flow spectrum and blood flow parameters are also correlated with gestational age.It is also an important index to evaluate fetal right heart function.3.The ratio of E/A in the tricuspid valve is always less than 1 in the fetal stage,4.which is different from that in adults and children.The reason is that the fetal heart fibers are relatively more and the myocardium is relatively stiff.The tricuspid E /A ratio can further reflect the fetal right ventricular diastolic function.4.The results of this study show that there is a correlation between the D wave of fetal superior vena cava and venous catheter(the function of ventricle diastole)and the ratio of E/A to tricuspid valve,which can further reflect the right ventricular diastolic function of fetus.In order to correctly and systematically evaluate the right ventricular diastolic function of the fetus,a new research direction and method can are provided.