Ultrasonic Characteristics Of Fetal Tricuspid Regurgitation In Early Pregnancy And Congenital Heart Disease Correlation Research

Objective to study the correlation between fetal tricuspid regurgitation（TR）ultrasonic characteristics and congenital heart disease（CHD）in early pregnancy(11-13⁺⁶weeks).Methods The single pregnant women who were diagnosed as TR by routine NT examination in early pregnancy were selected from January 2019 to December 2020 in the prenatal diagnosis center of General Hospital of XXX University and Ultrasound Medicine Department of XXX maternal and child health care hospital.All the pregnant women had accurate history of menelipsis.The gestational age assessed by ultrasound was consistent with the gestational age calculated by menelipsis history.There were no complications such as diabetes and heart disease.The head hip diameter was 45-84mm.The severity of TR,the thickening of NT and the abnormality of venous catheter（DV）in early pregnancy were recorded,and the following cardiac views were observed:four chamber view,right ventricular outflow tract view and three vessel trachea view to judge whether there was cardiac malformation.The correlation between the ultrasonic characteristics of TR in early pregnancy and severe CHD was analyzed according to the follow-up results.Results A total of 63 eligible fetuses were singletons,In the simple TR group,there were 25fetuses,including 20 mild TR,3 moderate TR and 2 severe TR.In the complex TR group,there were 38 fetuses,including 20 with mild TR,12 with moderate TR and 6 with severe TR.Fetal echocardiography in early pregnancy revealed 18 cases of severe CHD,all of which were induced labor after reexamination.There was significant difference between simple TR,complex TR and concomitant cardiac abnormalities（P<0.05）.There were significant differences between mild TR and moderate TR,mild TR and severe TR in simple TR group（P<0.01）,but there was no significant difference between moderate TR and severe TR.There was significant difference between mild TR and severe TR in complex TR group（P<0.01）,but there was no significant difference between mild TR and moderate TR,and between moderate TR and severe TR.There were significant differences between mild TR and moderate TR,mild TR and severe TR,moderate TR and severe TR in simple and complex tr group（P<0.01）.Among the 18 fetuses with cardiovascular abnormalities and TR,3 cases were in the primary TR cause（tricuspid valve structure abnormality）group,12 cases were in the right ventricular pressure load increase group in the secondary cause,4 cases were in the volume load increase group,and the arrhythmia group In 1 cases,there was no significant difference in the severity of fetal TR among the four groups（P>0.05）.In the primary TR cause（tricuspid valve structure abnormality）group,there was no statistically significant difference in the severity of TR caused by different causes（P>0.05）,and most of them were moderate to severe reflux.In the group with increased right ventricular pressure load,the severity of TR caused by different causes had no significant difference（P>0.05）,most of them were severe reflux,and most of them were pulmonary artery stenosis or atresia.In the right ventricular volume load increase group,there was no statistically significant difference in the severity of TR caused by different causes（P>0.05）,mostly mild to moderate reflux,and more common in aortic arch constriction and discontinuityConclusion 1.The severity of TR in early pregnancy is correlated with CHD.2.The reliability of TR with NT thickening and abnormal DV in early pregnancy topredict CHD is better than that of TR alone.3.The severity of TR caused by different causes is different.