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. 2020 Jun;93(1110):20191011.
doi: 10.1259/bjr.20191011. Epub 2020 Mar 25.

Diagnostic analysis of abnormal increase of PASP in fetus in middle- and late-stage pregnancy by color Doppler echocardiography

Hong Cui  1 , Juan Su  1 , Wen-Wen Liang  1 , Hong-Ling Wang  1 , Hui-Feng Wang  1
Affiliations

Diagnostic analysis of abnormal increase of PASP in fetus in middle- and late-stage pregnancy by color Doppler echocardiography

Hong Cui et al. Br J Radiol. 2020 Jun.

Abstract

Objective: Our study was conducted with an attempt to investigate the diagnostic analysis of abnormal increase of fetal pulmonary artery systolic pressure (PASP) in middle and late pregnancy by color Doppler echocardiography.

Methods: From August 2017 to January 2019, 52 fetuses with moderate or greater tricuspid high-speed regurgitation were retrospectively analyzed and selected as Group A. 88 fetuses with full-color blood flow of the two ventricles and symmetrical sizes of the cardiac cavities on both sides harboring tricuspid valve and mild regurgitation or a small amount of regurgitation were selected as Group B. The pulmonary artery blood flow acceleration time (AT) and right ventricular ejection time (ET) was measured, and the PASP was calculated.

Results: The tricuspid regurgitation velocity, tricuspid regurgitation pressure difference and PASP in Group A were higher than those in Group B (p < 0.05), and the AT and AT/ET values in Group A were lower than those in Group B (p < 0.05). Gestational age, tricuspid regurgitation velocity and tricuspid regurgitation pressure difference were positively correlated with PASP. However, AT/ET and AT value were negatively correlated with PASP.

Conclusion: The abnormal increase of pulmonary artery can be assessed by color Doppler echocardiography of fetal tricuspid regurgitation, which is worth popularizing and applying in clinic.

Advances in knowledge: It was suggested that the middle- and late-stage fetuses with moderate or greater tricuspid regurgitation and with >20 mmHg regurgitation pressure difference should be followed up in clinic. If PASP was ≥70 mmHg with symptoms of right heart failure, fetuses should be closely observed until 35-36 weeks old to ensure fetal safety and early delivery would be recommended.

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Figures

Figure 1.
Figure 1.
A. Correlation between age of pregnant females and PASP; B. Correlation between gestational age and PASP; C. Correlation between tricuspid regurgitation velocity and PASP; D. Correlation between tricuspid regurgitation pressure difference and PASP. PASP, pulmonary artery systolic pressure.
Figure 2.
Figure 2.
A. Correlation between PASP and AT; B. Correlation between PASP and ET in Group A; C. Correlation between PASP and AT/ET in Group A. AT,acceleration time; ET, ejection time; PASP, pulmonaryartery systolic pressure.
Figure 3.
Figure 3.
(A) The regurgitation bundle reached the middle of the right atrium; (B) The regurgitation bundle reaches the top of the right atrium.
See this image and copyright information in PMC

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