Quantitative Analysis of Fetal Heart to Assess Changes in Fetal Ventricular Function in Gestational Diabetes Mellitus
Objective To investigate the efficacy of fetal heart quantitative analysis(fetal HQ)in evaluating fetal ventricular function in gestational diabetes mellitus(GDM).Methods 105 pregnant women with GDM treated from Novem-ber 2021 to November 2023 were selected as the study subjects.Oral glucose tolerance test and ultrasound-related examination were performed at 24-28 weeks of gestation.The patients were grouped according to blood glucose control and follow-up of neo-natal heart structure/function abnormalities.40 pregnant women with normal pregnancy and single pregnancy were selected as the control group.Clinical data,conventional ultrasound and fetal HQ parameters of all groups were compared,and receiver operating characteristic(ROC)curve was used to analyze the efficacy of fetal HQ parameters in predicting the occurrence of neonatal cardiac structure/function abnormalities.Results Of 105 GDM patients,73 had good blood glucose control and 32 had poor blood glucose control.The pre-pregnancy BMI of the non-control group was significantly higher than that of the con-trol group and the control group(P＜0.05),and the Apgar score of the newborn at 1 min after birth was significantly lower than that of the control group and the control group(P＜0.05).Left ventricular area change fraction(LVFAC),left ventric-ular global longitudinal strain(LVGLS),left ventricular/right ventricular global longitudinal strain(LV/RVGLS),left ven-tricular global circumferential strain(LVGCS)and right ventricular free wall strain(RVFWSt)in control group were statisti-cally significant compared with control group(P＜0.05).LV/RVGLS in the control group was significantly lower than that in the control group(P＜0.05),LV/RVGLS and RVFWSt in the control group were significantly lower than that in the control group(P＜0.05).Among 105 pregnant women with GDM,10(9.52%)had abnormal fetal heart structure/function.LVFAC,LVGLS,LV/RVGLS,LVGCS and RVFWSt in abnormal group were significantly lower than those in normal group(P＜0.05,P＜0.01).ROC curve analysis showed that the area under the curve of LVFAC,LV/RVFAC,LVGLS,LV/RVGLS,LVGCS and RVFWSt in predicting the occurrence of neonatal heart structure/function abnormalities were 0.751,0.654,0.762,0.708,0.707 and 0.798,respectively.Conclusion fetal HQ can effectively quantitatively analyze fetal ventricular function with GDM,and can predict fetal cardiac structure/function abnormality.
Gestational diabetes mellitusQuantitative analysis of fetal heartThe fetusVentricular function
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