Department of Otolaryngology, Xijing Hospital, Air Force Military Medical University, Xi'an, Shaanxi, China.
Department of Ultrasound, Xi'an Daxing Hospital, Xi'an, Shaanxi Province, China.
J Matern Fetal Neonatal Med. 2024 Dec;37(1):2424892. doi: 10.1080/14767058.2024.2424892. Epub 2024 Nov 5.
fetal circulatory characteristics differ from those after birth; the right ventricle assumes more than 60% of the workload in the systemic circulation before birth. The right ventricle automated myocardial performance index (AM+MPI) is a simple, time-efficient, and stable assessment method used to evaluate overall cardiac function. This study aimed to apply the right ventricle AM+MPI technique to explore its role in normal mid-to-late pregnancy fetal cardiac function and compare the AM+MPI differences between diabetic and normal fetuses. A total of 150 pregnant women who visited the obstetric outpatient department at Daxing Hospital, Xi'an, from January 2022 to June 2022 were selected. We excluded 42 patients with comorbid conditions other than diabetes, fetal anomalies, and unclear last menstrual periods, resulting in 85 healthy pregnant patients and 17 diabetic pregnant patients. Using a Samsung WS80A color Doppler ultrasound diagnostic device, we measured the fetal right ventricle AM+MPI, isovolumic contraction time (ICT), isovolumic relaxation time (IRT), and ejection time (ET) in RMPI mode. We performed variability and correlation analyses within the normal group and compared these parameters with those of the diabetic group. In the healthy pregnant group, there was no significant variability in the fetal MPI, ET, or ICT values among the groups ( > 0.05). However, the IRT was positively correlated with gestational age ( < 0.05), with a linear fit formula of IRT = 29.78 + 0.49 × gestational age (DW value 1.87; = 32.25, < 0.05), indicating that the IRT increases with gestational age. The right ventricle MPI in the diabetic group was significantly greater than that in the normal group ( < 0.05). The right ventricle AM+MPI technique is simple, time-efficient, and stable and can objectively assess fetal right ventricle function, providing a theoretical basis for the early diagnosis of intrauterine cardiac function abnormalities. Additionally, there are significant differences in the right ventricle MPI between diabetic and normal fetuses, providing evidence for predicting fetal developmental issues and postnatal complications. The right ventricle AM+MPI holds promise as a new method for prenatal evaluation of fetal right heart function.
胎儿循环特点与出生后不同；在出生前，右心室承担超过 60%的体循环工作量。右心室自动心肌性能指数（AM+MPI）是一种简单、高效、稳定的评估整体心脏功能的方法。本研究旨在应用右心室 AM+MPI 技术探讨其在正常中晚期妊娠胎儿心功能中的作用，并比较糖尿病和正常胎儿的 AM+MPI 差异。
选取 2022 年 1 月至 6 月期间在西安大兴医院妇产科门诊就诊的 150 名孕妇，排除合并糖尿病以外的其他合并症、胎儿畸形、末次月经不清的孕妇 42 例，最终纳入健康孕妇 85 例，糖尿病孕妇 17 例。应用三星 WS80A 彩色多普勒超声诊断仪，在 RMPI 模式下测量胎儿右心室 AM+MPI、等容收缩时间（ICT）、等容舒张时间（IRT）和射血时间（ET）。对正常组内进行变异性和相关性分析，并与糖尿病组进行比较。
在健康孕妇组中，各组胎儿 MPI、ET 或 ICT 值无显著变异性（ > 0.05）。然而，IRT 与孕龄呈正相关（ < 0.05），IRT 的线性拟合公式为 IRT=29.78+0.49×孕龄（DW 值 1.87； = 32.25， < 0.05），表明 IRT 随孕龄增加而增加。糖尿病组右心室 MPI 明显大于正常组（ < 0.05）。
右心室 AM+MPI 技术简单、高效、稳定，可客观评估胎儿右心室功能，为宫内心脏功能异常的早期诊断提供理论依据。此外，糖尿病和正常胎儿的右心室 MPI 存在显著差异，为预测胎儿发育问题和产后并发症提供了依据。右心室 AM+MPI 有望成为胎儿右心功能产前评估的新方法。
