Measurement Of Cardiac Ultrasound Indexes And Determination Of Reference Values In Pregnant Women With Normal Pregnancy

OBJECTIVE: In the normal physiological pregnancy process,due to the increased burden of the cardiovascular system,a series of physiological changes will occur in the structure and function of the heart.Echocardiography is the first choice to evaluate the structure and function of the heart during pregnancy.However,there is a lack of evaluation criteria for echocardiography during pregnancy.This study is to compare the echocardiography parameters during different pregnancy trimesters and to determine the reference range of echocardiography for pregnant women.At the same time,through follow-up to explore whether there is a certain correlation between cardiovascular adverse events and echocardiographic indicators during pregnancy.METHODS: From February 2017 to March 2018,normal pregnant women were enrolled from four hospitals in Shanghai.Cardiac ultrasonography was performed in any one of the three trimesters or 42 days postpartum,and non-pregnant women of childbearing age were recruited as controls.The reference ranges of indicators were determined by each groups.Pregnant women were followed up to track their pregnancy outcomes.RESULTS: A total of 1822 normal pregnant and non-pregnant women were enrolled.Compared with non-pregnant women,there were significant differences in echocardiography parameters among these groups.This study successfully established a range of reference values for echocardiography indicators of normal pregnancy.Many echocardiographic indicators during pregnancy are different fromnon-pregnancy.With the increase of gestational age,the radial lines of left and right atria and ventricles enlarged;the aortic root diameter and pulmonary artery diameter increased and left and right heart systolic function declined.Most of the above changes reached a peak in the third trimester and did not return to the non-pregnancy level at 42 days postpartum.The diastolic function did not change significantly throughout pregnancy or 42 days postpartum.There were few cases of cardiovascular adverse events in the subjects,and the correlation with the echocardiographic indicators was not clear.Conclusion: During normal pregnancy,series of physiological changes in the structure and function of heart can be detected with the development of gestational age.The current normal reference range of echocardiography is not fully applicable to pregnant women.It is of great importance to establish a normal reference range of echocardiography for pregnant women.The incidence of cardiovascular adverse events during normal pregnancy is low,and frequent ventricular premature beats may be associated with enlarged left atrium and ventricles.