| Objective:The left ventricular function of normal fetuses and fetuses with hypertensive disorder complicating pregnancy was preliminarily studied by using two-dimensional speckle tracking imaging technology and Fetal HQ software.Combined with conventional evaluation methods,the application of two-dimensional speckle tracking imaging technology in the left ventricular function of fetuses with hypertensive disorder complicating pregnancy was evaluated.Methods:The normal pregnant women(80 cases)and HDP pregnant women(40 cases)who underwent echocardiography from November 2021 to December 2022 were selected as the normal control group and the study group,respectively.General clinical data were collected and followed up to 7 days postpartum.The conventional fetal cardiac evaluation indexes were measured: cardiothoracic ratio(CTR),peak E-wave velocity/peak A-wave velocity(E/A),umbilical artery blood flow parameters and heart rate.The changes of fetal cardiac function in the study group and the control group were compared;Using two-dimensional speckle tracking imaging technology,fetal global cardiac global index(GLS),left ventricular end diastolic volume(EDV),left ventricular end systolic volume(ESV),ejection fraction(EF),stroke volume(SV),cardiac output(CO)were measured Mitral valve septal movement(MAPSE S),mitral valve free lateral movement(MAPSE L),and left ventricular 24 segment sphericity index(SI).Fifteen fetuses were randomly selected to perform repeatability and consistency tests on the technical indicators of two-dimensional speckle tracking imaging to compare the difference in left ventricular function between the normal control group and the study group,The incidence of perinatal adverse outcomes was compared between low value fetuses and remaining fetuses in the study group using two-dimensional speckle tracking imaging techniques.Results:There was no significant difference in maternal age and gestational age between the two groups(P>0.05).The perinatal mortality rate in the study group was higher than that in the control group(10% vs 0),and the 1-minute Apgar score and 5-minute Apgar score of the newborn were lower than those in the control group(P<0.05);There was no significant difference in the median fetal CTR and E/A between the two groups(P>0.05);In the study group,3 fetal umbilical artery end diastolic blood flow signals disappeared,and the remaining fetal umbilical artery blood flow parameters were higher than those in the control group(P<0.05);The fetal heart rate in zhe study group was higher than in the control group;The two-dimensional speckle tracking imaging technology has good repeatability and consistency;The fetal GSI,EDV,ESV,SV,CO in the study group were lower than those in the control group(P;There was no statistically significant difference between the two groups in 24 segment SI of fetal left ventricle(P<0.05);The incidence of adverse fetal outcomes with low EDV and CO values was higher in the study group(P<0.05).Conclusions:HDP fetuses are prone to loss of umbilical artery diastolic blood flow signals,increased placental circulation resistance,and higher perinatal mortality than normal fetuses.Umbilical artery blood flow parameters can be used for routine evaluation of cardiac function in HDP fetuses.The two-dimensional speckle tracking imaging technique has good repeatability and consistency,and can be used to assess left ventricular function in HDP fetuses.The overall cardiac sphericity index(GSI)of HDP fetuses is lower than that of normal fetuses,and the heart tends to be more spherical.The left ventricular EDV,ESV,SV,and CO are lower than those of normal fetuses,suggesting that two-dimensional speckle tracking imaging technology can be more sensitive,reliable,and quantitative in assessing left ventricular deformation and function in HDP fetuses,and has certain clinical application value.Fetuses with low levels of EDV and CO are more likely to have poor perinatal outcomes,which have some predictive value for the perinatal outcomes of HDP fetuses. |
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