Ultrasonic Department, The Third Affiliated Hospital of Zhengzhou University (Maternal and Child Health Hospital of Henan Province), Zhengzhou, China.
Prenatal Diagnosis Center, The Third Affiliated Hospital of Zhengzhou University (Maternal and Child Health Hospital of Henan Province), Zhengzhou, China.
J Ultrasound Med. 2024 Jul;43(7):1199-1209. doi: 10.1002/jum.16444. Epub 2024 Mar 11.
Due to the government's liberalization of epidemic control, the current 2019 novel coronavirus disease (COVID-19) has started to spread widely within China. This study aimed to use the fetal heart quantification (fetal HQ) technique to assess the cardiac function and morphology of the fetuses of pregnant women diagnosed with COVID-19 in the early stages of pregnancy.
Exactly 86 pregnant women diagnosed with COVID-19 infection in early pregnancy (COVID-19 group) and 90 healthy pregnant women (control group) who underwent fetal echocardiography were prospectively included in this study. The fetal HQ technique was applied to compare the differences in the global sphericity index (GSI), global strain values (GS), fractional area change (FAC), and 24-segment fractional shortening (FS) of the left and right ventricles, between the COVID-19 group and the control group.
Compared with the control group, the differences in GS and 24-segment FS of the left ventricle in the COVID-19 group were not statistically significant. However, the COVID-19 group showed lower GSI values compared with the control group (1.24 vs 1.28). FAC (48.12%) of the left ventricle and GS (-23.55%), FAC (41.74%) of the right ventricle in the COVID-19 group were reduced compared with FAC (50.50%) of the left ventricle and GS (-27.63%), FAC (46.01%) of the right ventricle in the control group. Segmental analysis revealed reduced FS in segments 20-24 in the COVID-19 group compared with the control group. Right ventricular GS was an independent predictor of adverse pregnancy outcome with an optimal cutoff value of -18.66%.
The results suggest that COVID-19 infection in early pregnancy may have a negative impact on fetal cardiac morphology and function. Fetal HQ may offer a new assessment method for the early identification of fetal cardiac alterations in pregnant women infected with COVID-19.
由于政府对疫情防控的放宽，目前中国境内的 2019 新型冠状病毒病（COVID-19）开始广泛传播。本研究旨在使用胎儿心量化（fetal HQ）技术评估在妊娠早期被诊断为 COVID-19 的孕妇的胎儿心脏功能和形态。
本前瞻性研究共纳入 86 例妊娠早期被诊断为 COVID-19 感染的孕妇（COVID-19 组）和 90 例健康孕妇（对照组）。应用胎儿 HQ 技术比较 COVID-19 组和对照组左、右心室整体球形指数（GSI）、整体应变值（GS）、左心室面积变化分数（FAC）和 24 节段缩短分数（FS）的差异。
与对照组相比，COVID-19 组左心室 GS 和 24 节段 FS 的差异无统计学意义。然而，COVID-19 组 GSI 值较对照组低（1.24 比 1.28）。与对照组相比，COVID-19 组左心室 FAC（48.12%）和 GS（-23.55%）、右心室 FAC（41.74%）和 GS（-27.63%）、右心室 FAC（46.01%）和 GS（-27.63%）均降低。节段分析显示 COVID-19 组 20-24 节段 FS 较对照组降低。右心室 GS 是不良妊娠结局的独立预测因素，最佳截断值为-18.66%。
本研究结果表明，妊娠早期 COVID-19 感染可能对胎儿心脏形态和功能产生负面影响。胎儿 HQ 可能为评估 COVID-19 感染孕妇胎儿心脏改变提供一种新的方法。
