A preliminary study on fetal cardiac morphology and systolic function of normal and anemic pregnant women by fetal heart quantification technology

Yuqin Shen; Fang Tan; Jiaojiao Yang; Sihan Fan; Lianxiang Zhang; Xueqin Ji

doi:10.21037/tp-22-315

A preliminary study on fetal cardiac morphology and systolic function of normal and anemic pregnant women by fetal heart quantification technology

Transl Pediatr. 2022 Aug;11(8):1336-1345. doi: 10.21037/tp-22-315.

Authors

Yuqin Shen¹, Fang Tan², Jiaojiao Yang², Sihan Fan², Lianxiang Zhang³, Xueqin Ji⁴

Affiliations

¹ Functional Examination Department of Obstetrics and Gynecology Center, General Hospital of Ningxia Medical University, Yinchuan, China.
² Ningxia Medical University Clinical School of Medicine, Yinchuan, China.
³ Ningxia Medical University School of Basic Medicine, Yinchuan, China.
⁴ Department of Ultrasound Medicine, Ningxia Maternal and Child Health Hospital (Ningxia Children's Hospital), Yinchuan, China.

Abstract

Background: Maternal anemia is a common nutritional problem during pregnancy. Fetal heart quantification (fetal HQ) technology is used to quantitatively evaluate the size, shape, and contractile function of the fetal heart, which can reflect the development of the fetus in the uterus.

Methods: We used fetal HQ technology to evaluate the basal-apical length (BAL), the transverse width (TW) and the area (A) of the four chamber view at end-diastole in 77 normal fetuses and 40 fetuses of women with anemia. We analyzed the changes of fetal heart size and measured the global sphericity index (GSI), the fraction area change (FAC), and the global longitudinal strain (GLS). The sphericity index (SI) and the fractional shortening (FS) of 24 segments were analyzed to identify any changes of fetal heart morphology and systolic function. The normal range of Z value was set at -2 to 2.

Results: Fetal BAL, TW, A, and gestational age (GA) were positively linearly correlated, while GSI, GLS, and FAC had no significant correlation with GA. There was no significant difference in fetal BAL, TW, A, GLS, and FAC between the two groups (P>0.05). There was no significant difference in the FS of the 24 segments of the left and right ventricles between the two groups (P>0.05). There was no significant difference in the SI of the 1-24 segments of the right ventricle between the two groups (P>0.05). The difference in fetal GSI between the two groups was statistically significant (P<0.05). There was no significant difference in SI between the 1-22 segments of the left ventricle between the two groups (P>0.05), but there was a statistically significant difference between the 23-24 segments (P<0.05).

Conclusions: The fetal HQ analysis technology can quickly and simply quantitatively assess the size, shape, and contractility of the fetal heart. Anemia in pregnant women has no significant effect on fetal heart size and systolic function; it only affects the morphology of the heart, showing that the heart tends to be spherical as a whole and some segments of the apical segment of the left ventricle are abnormal.

Keywords: 24 segments; Fetal heart quantification technology; anemia in pregnant women; fetal heart function.