| The umbilical cord is a bridge between the mother and the fetus,which directly affects the blood supply of fetal growth and development.The nuchal cord is a common complication in obstetric department andthere is an increasing trend in recent years. The cord around the neck is oneof the main reasons of fetal hypoxia and hypoxia often leads to the changeof heart function. The aim of this study is to monitor the change ofventricular function of the fetus with nuchal cord by tissue Dopplerimaging Tei index. It can provide important information for the clinicalassessment of fetal status and prevent the occurrence of adverse pregnancyoutcomes.173fetuses were recruited from these who came to our hospital forpregnancy examination. These fetuses were between37and41+6weeks.They were divided into2groups: the nuchal cord group includes55fetuseswith nuchal cord and are confirmed by childbirth. the control groupincludes118fetuses without nuchal cord.115fetuses got the Tei index ofleft and right ventricular. The E8Ultrasonoscope were used to examinefetuses. The pregnant women were lying horizontally or on the side, firstly,examined the fetal structure and estimate gestational weeks, then, judgedwhether the fetus with umbilical cord around the neck and judge thenumber of cord around the neck. Doppler spectra of mitral and tricuspidannulus were obtained by Tissue Doppler Imaging on four-chamber view.The lefe and right myocardial performance index was calculated accordingto the formula: Tei index=(ICT+IRT)/ET, where ICT is isovolumetriccontraction time; IRT is isovolumetric relaxation time and ET is ejectiontime. The data should be the average value of three continuous heart beat cycle. All of the postnatal1min Apgar scores were in our follow-up study.SPSS17.0statistical software was used. The data was expressed asmean±SD. The t-test was applied in the intergroup comparison.Chi-square test was applied in count data. P-value less than0.05wasconsidered statistically significant. The relationship between two variablesusing Pearson correlation analysis.As shown above, the results showed as follows:1The measuring success rate of fetal left and right ventricular Teiindex.In the inspection process of118fetuses without nuchal cord,3fetuseshad not obtained satisfactory tissue doppler spectrum image because ofpregnant women obesity or fetal gestational age relatively large ortransverse occipital and had to give up the measurement of ICT+IRT andET. The other115fetuses obtained Doppler spectra of mitral and tricuspidannulus and measured ICT, IRT and ET, The index was calculatedaccording to the formula. The measuring success rate of fetal left and rightventricular Tei index is97.5%.2There was no correlation between ICT+IRT, ET and Tei index of thenormal fetal left and right ventricular and their gestational age(LV:r=-0.099,0.051,0.062, P=0.292,0.589,0.510, RV: r=0.066,0.057,-0.030,P=0.485、0.548、0.751).3There was a negative correlation between ICT+IRT, ET and fetalheart rate of the normal fetal, there was no correlation the Tei index andfetal heart rate(LV: r=-0.531,-0.482,-0.019, P=0.000,0.000,0.844, RV:r=-0.447,-0.410,0.124, P=0.000,0.000,0.186).4ICT＋IRT, ET and Tei index had no difference between LV andRV(P＞0.05).5The Tei index and ICT+IRT in nuchal cord group were higher thanthose in control group(P<0.05), there was no difference of ET between thetwo groups(P>0.05). 6Neonatal asphyxia rate in nuchal cord group was higher than that inthe control group(P<0.05).7There was a negative correlation between the Tei index of fetus withnuchal cord and1min Apgar scores (LV: r=-0.727, P=0.000, RV: r=-0.640,P=0.000).In summary, the Tei index of fetal heart left and right ventricular issimple to measure, repeatable, obtaining rate is97.4%. The Tei index ofnormal fetal LV and RV is not affected by pregnant weeks and heart rate.The Tei index of fetuses in nuchal cord group were higher than those offetuses in control group, neonatal asphyxia rate in nuchal cord group washigher than that in the control group, there was a negative correlationbetween the Tei index of fetuses with nuchal cord and1min Apgar scores.The Tei index can be used to evaluate the change of ventricular function infetuses with nuchal cord. To judge the fetus lack of oxygen and estimatingprognosis has certain clinical application value. |
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