Tei Index Combined With Pulmonary Vein And Ductus Venosus Blood Flow Parameters To Evaluate Fetal Cardiac Function In Pregnancy-induced Hypertension

Hypertensive disorders complicating pregnancy(HDCP)is a specific disease of pregnancy,often occur in the gestational age is greater than or equal to 20 weeks pregnant women,has led to higher morbidity and mortality among pregnant women and perinatal children.Its pathophysiological changes are the contractions of the small arteries in the whole body of pregnant women,which causes the increase of circulating resistance of the uterine placenta,hypoxia of the placenta,decreased function and thus fetal ischemia and hypoxia reduces cardiac function,and the serious case can cause fetal death.This study used Tei index combined with pulmonary vein(PV)and ductus venosus(DV)to assess the overall function and diastolic function of fetal left and right heart in patients with gestational hypertension,thus providing objective basis for clinical assessment of fetal intrauterine state and the establishment of reasonable treatment plan.In this study,226 pregnant women,whose gestational ages were between 28 and 41+6 weeks,and whose ages were between 25 and 34 years old,were selected as the study subjects.According to whether or not the HDCP was divided into the normal control group(145 cases)and the disease group(81 cases),the disease group was confirmed by clinical and laboratory tests.Using GE Voluson E6 color doppler ultrasound diagnostic instrument(C1-5 convex array probe,frequency: 2~5MHz;The RIC-5-9-D convex unit product probe,frequency: 5~9MHz).First,the general obstetric ultrasonography was performed to measure fetal double top diameter,head circumference,abdominal circumference,femur length and other parameters to assess gestational age,evaluate fetal growth and development,and then each fetuses were examined by echocardiography in cardiac disease itself except.Using tissue Doppler imaging(TDI)technique to obtain all the fetal posterior mitral valve and mitral ring joints,three tricuspid anterior lobe and three tricuspid ring junction motion spectrum,measured left and right ventricular isovolumic contraction time,isovolumic relaxation time and ejection time.The calculation of left and right ventricular Tei index.Using pulsed Doppler(PW)method to obtain all the fetal PV and DV blood flow spectrum,measurement and calculation of related parameters,including the following parameters: ventricular peak systolic velocity S,ventricular diastolic peak velocity D,systolic peak velocity of atrial A,S/A,PI(pulsatility index),PVIV(peak velocity index for veins).To compare the changes of the left and right ventricle Tei indexes and the parameters of pulmonary vein and venous catheter in two groups,the fetal heart function was evaluated.All fetuses were followed up for 1 min after birth for Apgar scores.Using SPSS17.0 statistical software.The measurement data was expressed as mean±SD.The independent samples t-test was used for comparison between the two groups.The correlation analysis was Pearson correlation analysis.The chi-square test was used for the count data.P-value less than 0.05 was considered statistically significant.The results showed as follows:1 There was no significant difference in the pregnancy age,gestational age and fetal heart rate between the control group and the disease group(P>0.05).2 There was no correlation between Tei index of the normal fetal LVand RV and their heart rate(RV: r=0.033,P>0.05;LV: r=0.016,P> 0.05).3 There was no significant difference in the Tei index between the left and right ventricles of the control group(P>0.05).4 The fetal left and right ventricular Tei index in the disease group were higher than those of the control group(P<0.05).5 The fetal pulmonary vein and ductus venosus blood flow parameters S,D and A in the disease group were lower than those of the normal group(P<0.05).6 The fetal pulmonary vein and ductus venosus index S/A,PI and PVIV in the disease group were higher than those of the normal group(P<0.05).7 The PV blood flow parameters of the fetuses in the disease group were positively correlation with left ventricular Tei index(S/A: r=0.485,P<0.05;PI: r=0.462,P<0.05;PVIV: r=0.456,P<0.05).8 The DV blood flow parameters of the fetuses in the disease group were positively correlation with right ventricular Tei index(S/A: r=0.454,P<0.05;PI: r=0.442,P<0.05;PVIV: r=0.426,P<0.05).9 The rate of fetal asphyxia in the disease group were higher than those of the normal group(P<0.05).In summary,the fetal left and right ventricular Tei index can be used to evaluate the whole heart function,the fetal PV and DV can be used to evaluate the cardiac diastolic function,they jointly monitor the fetal heart function,which can reflect the changes of fetal hemodynamics and cardiac function in a timely and comprehensive way,in order to make the best clinical treatment quickly.