胎儿心脏定量分析技术评估辅助生殖胎儿心脏形态和功能

Using fetal heart quantification to assess fetal heart morphology and function in assisted reproductive technolog

目的:探讨胎儿心脏定量分析(fetal HQ)技术在辅助生殖技术(ART)胎儿心脏功能及形态评价中的应用价值。方法:本研究共纳入60例ART受孕胎儿(ART组),冻胚移植与鲜胚移植各30例,67例自然受孕胎儿(对照组)。应用fetal HQ软件计算得出整体球形指数(GSI)、左右心室整体应变值(GS)、面积变化分数(FAC)、24节段球形指数(SI)。应用Pearson相关性分析孕妇年龄、孕周、胎儿预估体质量、体质量指数、胎儿心率与心脏各参数的相关性。结果:(1)与对照组相比,ART组孕妇年龄更大、产次更少(P<0.05),其它临床特征差异无统计学意义(P>0.05)。(2)ART组胎儿与对照组比较GSI、GS、FAC、右室2~24节段SI值差异有统计学意义(P<0.05);按移植方式进行亚组分析,冻胚组与对照组GSI及右室GS、右室FAC存在差异;鲜胚组与对照组GSI、GS、FAC存在差异;冻胚组与鲜胚组右室GS、右室FAC存在差异(P<0.05)。(3)相关性分析显示孕妇年龄、孕次、产次、胎儿预估体质量、体质量指数、胎儿心率、孕周与心脏各参数之间均无相关关系。结论:fetal HQ可以反映ART胎儿心脏心功能变化、整体及各节段形态变化,为中孕期ART胎儿心脏改变的早期识别提供了一种新的评估方法。

Objective:To explore the application value of fetal heart quantification(fetal HQ)technology in the evaluation of fetal heart function and morphology in assisted reproductive technology(ART).Methods:This study included a total of 60 ART-conceived embryos(ART group),with 30 cases of frozen embryo transfer and 30 cases of fresh embryo transfer,as well as 67 naturally conceived embryos(control group).Fetal HQ software was used to calculate the global spherical index(GSI),global strain(GS)values of the left and right ventricles,fractional area change(FAC),and 24-segmental spherical index(SI).Pearson correlation analysis was used to analyze the correlations between maternal age,gestational age,estimated fetal weight,body mass index,fetal heart rate,and various cardiac parameters.Results:Compared with the control group,the ART group had older maternal age and fewer pregnancies(P<0.05),but there were no statistically significant differences in other clinical characteristics(P>0.05).②The ART group had lower GSI,GS,FAC,and right ventricle SI values compared to the control group,and the differences were statistically significant(P<0.05).Subgroup analysis based on the transplantation method showed differences in GSI and right ventricle GS,right ventricle FAC between the frozen embryo group and the control group.as well as differences in GSI,GS,and FAC between the fresh embryo group and the control group,and differences in right ventricle CS and right ventricle FAC between the frozen embryo group and the fresh embryo group(P<0.05).The correlation analysis showed no correlation between maternal age,pregnancies,pregnancies,estimated fetal weight,body mass index,fetal heart rate,gestational age and various cardiac parameters.Conclusion:Fetal HQ can reflect the overall cardiac function changes,as well as the overall and segmental morphological changes of the ART fetus heart,providing a new assessment method for early identification of changes in the heart of ART fetus in mid-pregnancy.