| ObjectiveIn this study we detected the related index of fetal cardiac function in health normaland preeclampsia fetal by ultrasound, which was conducted to explore the change ofplacenta resistance and fetal left ventricular function in preeclampsia, to explore thesensitivity of some of the parameters in evaluating cardiac function of preeclampsia fetus.And we were aiming to provide a theoretical basis for preeclampsia fetus clinicalmonitoring and neonatal prognosis.MethodWe chose pregnant women in our hospital for prenatal examination from May,2012to October,2011. According to disease severity, we divided them into two groups: mildpreeclampsia (MPE) group of28cases, severe preeclampsia (SPE) group of24cases.60cases healthy pregnant women were chosen as the control group. When women withpreeclampsia admitted to hospital, they received conventional fetal ultrasound and fetalechocardiography. we detected the related index of fetal cardiac function by medicalultrasonic equipments of GE Voluson E8、Philips iE33, such as ejection fraction(EF),fraction shortening(FS), aortic peak systolic velocity(AO-PSV), Mitral valve earlyventricular filling(MVE), Mitral valve active atrial ventricular filling(MVA), isovolumetrictime(ICT+IRT), ejection time(ET), umbilical artery S/D, pulsation index, resistance index.Result1. Comparison of Systolic function:(1) Ejection fraction(EF): Control group, MPE group, SPE group were69.77±2.70,65.91±3.31,64.13±3.44, Control group and MPE group, SPE group differences werestatistically significant (all P <0.01), There was no significant difference between MPE group and SPE group (P>0.05).(2) Factional shortening(ES): Control group, MPE group, SPE group were35.26±1.77,32.98±2.03,32.47±2.28, Control group and MPE group, SPE group werestatistically significant (all P <0.01), There was no significant difference between MPEgroup and SPE group (P>0.05).(3) Aortic peak systolic velocity(AO-PSV): Control group, MPE group, SPE groupwere95.65±9.15cm/s、94.66±8.05cm/s、94.47±7.40cm/s,3groups were not statisticallysignificance (P>0.05).2. Comparison of diastolic function:(1) Mitral valve orifice E peak flow velocity(MVE): Control group, MPE group,SPE group were36.23±4.40cm/s,36.78±4.90cm/s,35.66±5.23cm/s, but thedifference between the three groups were no statistically significant (P>0.05).(2) Mitral valve orifice A peak flow velocity (MVA) Control group, MPE group,SPE group were51.36±4.97cm/s,50.89±6.34cm/s,48.57±6.26cm/s, but thedifference between the three groups were no statistically significant (P>0.05).(3) Mitral E/A ratio: Control group, MPE group, SPE group were0.703±0.058,0.724±0.048,0.732±0.065, but the three groups showed no significant difference (P>0.05).3. Comparison of myocardial performance index:(1) Isovolume time: Control group(ICT+IRT), MPE group, SPE group were65.40±7.42ms,83.28±7.87ms,86.04±7.50ms, Control group and MPE group, SPE groupdifferences were statistically significant (both of P <0.01), There was no significantdifference between MPE group and SPE group (P>0.05).(2) Left ventricular ejection time(ET): for the Control group, MPE group, SPEgroup were176.89±10.32,171.78±10.34ms,170.71±8.31ms, Control group and MPEgroup difference was not statistically significant (P>0.05), with statistical significance (asP <0.05), MPE group and SPE groups showed no significant difference (P>0.05).(3) Left ventricular Tei index: Control group, MPE group, SPE group were0.369± 0.032,0.483±0.028,0.503±0.028, Control group and MPE group, SPE group differenceswere statistically significant (all P <0.01), but there was no significant difference betweenMPE group and SPE group (P>0.05).4. Comparison of umbilical artery parameters:(1) Umbilical artery S/D ratio: Control group, MPE group, SPE group were2.31±0.22,2.56±0.35,2.72±0.38, Control group and MPE group, SPE group differences werestatistically significant (both of P <0.01), but there was no significant difference betweenMPE group and SPE group (P>0.05).(2) Umbilical artery PI ratio: Control group, MPE group, SPE group were0.89±0.09,0.95±0.15,1.04±0.16, Control group and the SPE group difference was statisticallysignificant (as P <0.01), There was no significant difference between MPE group and SPEgroup, MPE group and Control group (P>0.05).(3) Umbilical artery RI ratio: Control group, MPE group, SPE group were0.59±0.05,0.62±0.06,0.66±0.07, Control group and the SPE group difference wasstatistically significant (as P <0.01), There was no significant difference between MPEgroup and SPE group, MPE group and Control group (P>0.05).ROC curve analysis:Tei index in the area under the ROC curve was0.979, EF area under the ROC curvewas0.157, EA ratio of the area under the ROC curve was0.589, the ratio of the umbilicalartery SD area under the ROC curve was0.764.Correlation analysis:The Tei index of MPE group was not related to gestational age and5minutes Apgarscore (respectively r=-0.013, P=0.949and r=-0.197, P=0.314), and was related tofetal weight and1minute Apgar score (respectively r=-0.451, P=0.016and r=-0.485, P=0.009); The Tei index of SPE group was not related to gestational age and5minutesApgar score (respectively r=-0.064, P=0.765and r=-0.201, P=0.346), and was relatedto fetal weight and1minute Apgar score (respectively r=-0.513, P=0.01and r=-0.546,P=0.006). Conclusion1. Ultrasound parameters could be good indicators in evaluating fetal ventricularfunction and monitoring intrauterine environment. The indicators of systolic and overallcardiac function and afterload in preeclampsia fetus were changed.2. Tei index in the evaluation of fetal left ventricular function is more sensitive thanEA ratio and EF,.3. The fetal Tei index in preeclampsia has a negative correlation with its newbornbirth weight and1minute Apgar score, which showed some practical value in theevaluation of fetal outcome. |
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