Advances in Clinical and Experimental Medicine
2018, vol. 27, nr 12, December, p. 1723–1727
Publication type: original article
Clinical applicability of monitoring pulmonary artery blood flow acceleration time variations in monitoring fetal pulmonary artery pressure
1 Department of B-Ultrasound, Fourth People’s Hospital of Jinan, China
2 Department of B-Ultrasound, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
3 Department of Emergency Surgery, Shandong Province Qianfoshan Hospital, Shandong University, Jinan, China
Background. In recent years, pulmonary artery blood flow acceleration time (AT) has been believed to be applicable in the examination of fetal lung development.
Objectives. This study aims to evaluate the clinical significance of pulmonary artery blood flow AT as a parameter in monitoring of fetal pulmonary artery pressure.
Material and Methods. A total of 31 fetuses in midor late-term pregnancy with tricuspid regurgitation were set as the study group (congenital heart disease with a tricuspid regurgitation pressure difference of more than 20 mm Hg was excluded). A total of 68 normal fetuses in midor late-term pregnancy were selected as the control group (strictly screened for tricuspid regurgitation, congenital heart disease and other congenital diseases before inclusion). The average ATs of both groups were calculated. Correlations of pulmonary artery systolic pressure (PASP) and AT, as well as the ratio of AT to right ventricular ejection time (ET) (AT/ET ratio) of both groups were investigated by 1-way analysis of variance (ANOVA).
Results. The average AT of the study group was significantly lower than that of the control group (p < 0.0001). In the study group, AT negatively correlated with PASP (r = –0.52; p < 0.01), AT/ET ratio negatively correlated with PASP (r = –0.52; p < 0.01) and both showed statistical significance.
Conclusion. The results indicated that fetuses in the study group showed lower ATs and AT/ET ratios than the control group. Acceleration times and AT/ET ratios decreased as PASP increased. Thus, AT and AT/ET ratio can be used clinically as new parameters for the qualitative and – to some extent – quantitative evaluation of fetal pulmonary artery pressure.
pulmonary artery systolic pressure, fetal ultrasonic cardiogram, pulmonary artery blood flow acceleration time
- Schenone MH, Samson JE, Jenkins L, Suhag A, Mari G. Predicting fetal lung maturity using the fetal pulmonary artery Doppler wave acceleration/ejection time ratio. Fetal Diagn Ther. 2014;36(3):208–214. doi: 10.1159/000358299
- Kim SM, Park JS, Norwitz ER, et al. Acceleration time-to-ejection time ratio in fetal pulmonary artery predicts the development of neonatal respiratory distress syndrome: A prospective cohort study. Am J Perinatol. 2013;30(10):805–812. doi: 10.1055/s-0032-1333132
- Guan Y, Li S, Luo G, et al. The role of Doppler waveforms in the fetal main pulmonary artery in the prediction of neonatal respiratory distress syndrome. J Clin Ultrasound. 2015;43(6):375–383. doi: 10.1002/jcu.22219
- Rychik J, Ayres N, Cuneo B, et al. American Society of Echocardiography guidelines and standards for performance of the fetal echocardiogram. J Am Soc Echocardiogr. 2004;17(7):803–810.
- Lindeley W, Hale R, Spear A, et al. Does corticosteroid impact fetal pulmonary artery blood flow in women at risk for preterm birth? Med Ultrason. 2015;17(3):280–283. doi: 10.11152/mu.2013.2066.173.wly
- Dabestani A, Mahan G, Gardin JM, et al. Evaluation of pulmonary artery pressure and resistance by pulsed Doppler echocardiography. Am J Cardiol. 1987;59(6):662–668.
- Chuanxi L, Chuiping L. Screening and Diagnosis of Fetal Heart Malformation by Color Doppler Ultrasound. Beijing, China: Scientific and Technical Documents Publishing House; 2003.
- Chaoui R, Taddei F, Rizzo G, Bast C, Lenz F, Bollmann R. Doppler echocardiography of the main stem of the pulmonary arteries in the normal human fetus. Ultrasound Obstet Gynecol. 1998;11(3):173–179.
- Kitabatake A, Inoue M, Asao M, et al. Noninvasive evaluation of pulmonary hypertension by a pulsed Doppler technique. Circulation. 1983;68(2):302–309.
- Granstam SD, Björklund E, Wikström G, Roos MW. Use of echocardiographic pulmonary acceleration time and estimated vascular resistance for the evaluation of possible pulmonary hypertension. Cardiovasc Ultrasound. 2013;11(1):7. doi: 10.1186/1476-7120-11-7
- Pavankumar P, Venugopal P, Kaul U, et al. Closed mitral valvotomy during pregnancy: A 20-year experience. Scand J Thorac Cardiovasc Surg. 1988;22(1):11–15.
- Pawelec M, Dżugalik M, Pietras J, Bełza Ł, Latkowski Ł. Medical and ethical considerations related to viable fetuses with trisomy 13 in the 36th week of pregnancy: A review of the literature. Adv Clin Exp Med. 2015;24(5): 911–921. doi: 10.17219/acem/26324
- DiBardino DJ, Jacobs JP. Current readings: Long-term management of patients undergoing successful pediatric cardiac surgery. Semin Thorac Cardiovasc Surg. 2014;26(2):132–144. doi: 10.1053/j.semtcvs. 2014.08.002
- Barczykowska E, Szwed-Kolińska M, Wróbel-Bania A, Ślusarz R. The use of central venous lines in the treatment of chronically ill children. Adv Clin Exp Med. 2014;23(6):1001–1009. doi: 10.17219/acem/37359
- Chiappa E, Micheletti A, Sciarrone A, Botta G, Abbruzzese P. The prenatal diagnosis of and short-term outcome for patients with congenitally corrected transposition. Cardiol Young. 2004;14(3):265–276.
- Hansel J, Burgstahler C, Medler S, Axmann D, Niess AM, Tetzlaff K. Effect of simulated diving trips on pulmonary artery pressure in healthy men. Clin Res Cardiol. 2012;101(12):947–953. doi: 10.1007/s00392-012-0482-9