Evaluation Fetal Right Ventricular Function In Hypertensive Pregnancy Using Electronic Matrix Time-space Correlation Imaging (e-STIC) Technology Combined Tei Index

Objective:To investigate the clinical value of virtual organ computer-aided analysis(VOCAL)acquired by electronic matrix time-space correlation imaging(e-STIC)technology combined Tei index in evaluation fetal right ventricular function during pregnancy-induced hypertension.Methods:Ninety-three pregnant women with hypertensive disorders in pregnancy who underwent ultrasound examination during pregnancy at our hospital were selected.Inclusion criteria:(1)singleton pregnancy(2)no fetal anatomical abnormalities(3)accurate last menstrual period and 32-39+6 weeks of gestation(4)hypertension after pregnancy and no hypotensive treatment before this ultrasound examination.Exclusion criteria: fetus with anatomical abnormalities,pregnant women with other diseases besides gestational hypertensive disorders,and poor image quality.Ninety-three pregnant women with gestational hypertensive disorders were divided into three groups: 40 in the gestational hypertension(GH)group,28 in the mild preeclampsia(MPE)group,and 25 in the severe preeclampsia(SPE)group.Eighty-five pregnant women who underwent pregnancy ultrasound examination in our hospital during the same period were selected to match the age,gestational age(weeks)and gestational frequency of the study group as the control group.A GE Voluson E10 ultrasound diagnostic instrument with electronic matrix probe model e M6C-G2 at 4-8 MHz was used.Use Fetal Echo software and four-dimensional processing software(4D View).Acquisition of fetal right ventricular end-diastolic volume(EDV)and end-systolic volume(ESV)using the VOCAL function in e-STIC technology to calculate right ventricular ejection fraction(RVEF).Spectral Doppler was applied to obtain fetal right ventricular isovolumic time and ejection time,and thus calculate the right ventricular Tei index.Results:1.There were no statistical differences between the control,GH,MPE and SPE groups in terms of maternal age,gestational age(weeks),gestational frequency and fetal heart rate among the examined subjects(P>0.05).2.There was no statistically significant difference between right ventricular EDV,ESV,SV,CO,and EF in the GH group compared with the control group(P > 0.05);there was no statistically significant difference between right ventricular EDV,ESV,SV,and CO in the MPE group compared with the control group(P > 0.05),and RVEF decreased compared with the control group(P < 0.05);right ventricular EDV,ESV increased in the SPE group compared with the control group,and SV,CO,and EF decreased,and the differences were statistically significant(P < 0.01,P < 0.05).3.The differences in right ventricular isovolumic time,ejection time and Tei index in the GH group compared with the control group were not statistically significant(P >0.05);the differences in right ventricular isovolumic time and ejection time in the MPE group compared with the control group were not statistically significant(P > 0.05),and the Tei index increased compared with the control group(P < 0.01);the differences in right ventricular isovolumic time and right ventricular Tei index in the SPE group compared with the control group increased and right ventricular ejection time decreased in the SPE group compared with the control group,with statistically significant differences(P < 0.01,P < 0.05).4.ROC curve analysis: the area of Tei index under the ROC curve was 0.735,with a sensitivity of 91.3% and a specificity of 38.8%;the area of RVEF under the ROC curve was 0.283,with a sensitivity of 34.8% and a specificity of 89.4%.Conclusion:(1)The RVEF measured by the Tei index and the VOCAL function of the e-STIC technique has good stability,the Tei index has high sensitivity and the ejection fraction has high specificity,and the combined two indexes are more accurate and sensitive in evaluating the changes of fetal cardiac function in the state of gestational hypertension.(2)Fetal right ventricular function is impaired in preeclampsia.The VOCAL function of e-STIC technology combined with Tei index can reflect the changes of fetal right ventricular function in maternal hypertensive state and provide clinical help.