| Objective TEl index and ejection fraction are Doppler derived myocardial performance tool which can be used to assess aspects of systolic and diastolic function. The aim of this study is to establish the reference ranges of Tei index and ejection fraction in norma1 fetuses of vary gestation weeks and to observe its diversifications in gestational hypertension disease.Methods 209 normal fetus whose gestation weeks varying from 20 to 42 were measured by color doppler ultrasound. Tei index of 200 cases was real measured. 200cases divided into five groups: 20-23+6 weeks forⅠgroup (45 cases); 24-27+6 weeks forⅡgroup (55 cases); 28-31+6 weeks forⅢgroup (35 cases); 32-36+66 weeks forⅣgroup (30 cases); 37-41+6 weeks forⅤgroup (35 cases). 92 preeclampsia fetuses were divided according to severity. There were 27 cases in gestational hypertension group, 28 cases in mild preeclampsia group, 37 cases in severe preeclampsia group. All fetuses were carefully examined with SIEMENS Antares Doppler ultrasound of left and right ventricular isovolumic time and ejection time to court Tei index. We also measured ejection fraction and other normal conventional indicators of fetal. After 28 gestation weeks, umbilical blood flow was to be measured.Results 1. We have measured fetal Tei index successly of 200 cases in 209 normal fetuses. The detecting rate was 95.69%; 2. Left Tei index of 200 cases (fromⅠtoⅤ) in different gestation weeks were 0.32±0.04; 0.31±0.04; 0.30±0.04; 0.30±0.03; 0.29±0.03; Right Tei index in different gestation weeks were 0.32±0.04; 0.32±0.03; 0.32±0.05; 0.31±0.04; 0.30±0.03. After statistical analysis, LV Tei index was 0.30±0.04 and RV Tei index was 0.31±0.04; Overall analysis of LV and RV Tei index showed a normal distribution, RV Tei index was slightly higher than LV Tei index, but no significant difference (P>0.05); 3. No significant changes of LV and RV Tei index were observed in fetuses with increasing gestational age, fetal heart rate or fetal birth weight (P>0.05); 4. Left and right ventricular function were no significant difference between GH,MPE and normal fetuses (P>0.05); Left and right ventricular function were significant difference between SPE fetuses and other three groups (P<0.01). RV Tei index was statistically higher than LV Tei index in SPE group (P<0.05); 5. LV EF of 200 cases (fromⅠtoⅤ) in different gestation weeks were 55.93±5.79; 56.01±5.49; 56.93±5.25; 57.62±6.00; 57.49±5.34; RV EF in different gestation weeks were 54.68±6.02; 55.12±5.36; 55.58±5.65; 55.64±6.31; 56.13±5.33. After statistical analysis, LV EF was 56.60±5.54 and RV EF was 55.33±5.65; Overall analysis of LV and RV EF showed a normal distribution, LV EF was slightly higher than RV EF and had significant difference (P<0.05); 6. No significant changes of LV and RV EF were observed in fetuses with increasing gestational age, fetal heart rate or fetal birth weight (P>0.05); 7. Left and right EF were no significant difference between GH, MPE and normal fetuses (P>0.05); Left and right EF were significant difference between SPE fetuses and other three groups (P<0.01); 8.After 28 gestation weeks, normal fetal umbilical blood flow S/D is lower than 3, which decreased with increasing gestation week; 9.The umbilical arterial blood flow parameters (PI, RI and S/D) tended to increase with the severity of preeclampsia. The values of these parameters in GH group, MPE group were slightly higher than normals group but no significant differences we observed between them (P>0.05). The values of these parameters were significantly higher in patients with severe preeclampsia than normal group and have significant diferences (P<0.01); 10. The mean birth weight of the newborns, 1 minuate Apgar scores of MPE group were significantly lower than normal group (P<0.05). The mean birth weeks, the mean birth weight of the newborns, Apgar scores were significantly lower than normal group (P<0.01). The incidence of fetal growth restriction and perinatal mortality were no significant diferences between the GH group, MPE group and the normal group (P>0.05). But significant diference was found in these parameters between SPE group and the normal group (P<0.01).Conclusions The Tei index can be easily obtained in the fetus and the detecting rate is 95.69%. The change of Tei index and ejection fraction of normal fetus in different gestational weeks is not obvious. They are not change with fetal heart rate. Their stability is fine. Tei index and ejection fraction can be used as good indicators to assess aspects of systolic and diastolic function. Fetal left and right ventricular function in preeclampsia are impaired, especially in SPE. Umbilical artery blood flow parameters (S/D, PI, RI) as indicators for determining the fetal status can be used as a simple, non-invasive means to predict pregnancy outcomes of severe preeclampsia. |
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