Evaluation of fetal ventricular systolic function in women with intrahepatic cholestasis of pregnancy by quantitative fetal heart analysis

Abstract:

Objective To investigate the influence of intrahepatic cholestasis of pregnancy（ICP） on fetal ventricular systolic function，and to provide a basis for the early identification of fetal cardiac dysfunction in ICP.Methods A total of 67 pregnant women at 27-40 weeks of pregnancy who attended Affiliated Hospital of North Sichuan Medical College from July 2022 to April 2023 were enrolled，among whom there were 29 women with ICP（ICP group） and 38 normal pregnant women（control group）. Quantitative fetal heart analysis software was used to measure fetal ventricular systolic function，including longitudinal systolic function（global longitudinal strain ［GLS］，septal wall strain［SWS］，and free wall strain［FWS］ of the left and right ventricles），traverse systolic function（24-segment fractional shortening［FS］ of the left and right ventricles），and global systolic function（fetal area change［FAC］ of the left and right ventricles and ejection fraction［EF］ of the left ventricle）.Results As for longitudinal systolic function，the ICP group had significantly lower GLS，SWS，and FWS of the left and right ventricles than the control group（P<0.05）. As for traverse systolic function，there was no significant difference in the 24-segment FS of the left and right ventricles between the two groups（P>0.05）. As for global systolic function，the ICP group had significantly lower FAC of the left and right ventricles than the control group（P>0.05），while there was no significant difference in EF of the left ventricule between the two groups（P>0.05）.Conclusion In the intrauterine environment with high bile acid，the global systolic function and longitudinal systolic function of the left and right ventricles are significantly impaired in the fetus of women with ICP，and there is no significant change in traverse systolic function. Compared with EF of the left ventricule as the traditional indicator for evaluating cardiac function，FAC can be a more sensitive indicator in reflecting the changes of fetal heart function.