Gestation-specific reference intervals for right and left ventricular ejection force from 12 to 40 weeks of gestation

Area of Science:

• Cardiovascular Physiology
• Fetal Medicine
• Medical Imaging

Background:

• Fetal cardiac ventricular ejection force (VEF) has been previously described from 18 weeks gestation.
• Establishing early gestation reference intervals is crucial for understanding fetal cardiac development.

Purpose of the Study:

• To establish gestation-specific reference intervals for fetal ventricular ejection force (VEF) from 12 to 40 weeks of pregnancy.
• To assess the feasibility of measuring Doppler indices in early pregnancy.

Main Methods:

• A cross-sectional observational study involving 236 singleton pregnancies from 12 to 40 weeks gestation.
• Doppler echocardiography was used to measure aortic and pulmonary valve parameters, including time to peak velocity (TPV), average flow velocity (TAV), and peak systolic velocity (PSV).
• Ventricular ejection force (VEF) was calculated using a validated formula, with reproducibility assessed for intraobserver and interobserver variability.

Main Results:

• Reference intervals for right and left ventricular ejection force (VEF) are presented.
• A significant increase in both right and left VEF was observed with advancing gestational age.
• Doppler indices for fetal cardiac physiology can be reliably measured from the late first trimester.

Conclusions:

• Fetal cardiac physiology and ventricular ejection force can be reliably assessed using Doppler indices as early as the late first trimester.
• Future studies can explore the relationship between VEF and fetal growth.
• This research may enhance understanding of conditions predisposing to adult cardiac disease.