Foetal cardiac function in third trimester pregnancies with reduced fetal movements

Area of Science:

• Obstetrics and Gynecology
• Fetal Medicine
• Cardiology

Background:

• Reduced fetal movement (RFM) is linked to adverse pregnancy outcomes.
• Current assessment methods like cardiotocography have limited sensitivity in detecting fetal compromise.
• There is a need for more sensitive tools to evaluate fetal well-being in RFM pregnancies.

Purpose of the Study:

• To investigate the relationship between fetal cardiac function and poor perinatal outcomes in pregnancies with RFM.
• To evaluate specific echocardiographic parameters as predictors of adverse outcomes in RFM cases.

Main Methods:

• A cross-sectional study comparing fetal cardiac function in women with normal fetal movements versus those with RFM.
• Echocardiographic assessment included E/A ratio, myocardial performance index (MPI), and fetal tricuspid annular plane systolic excursion (f-TAPSE).
• Group 2 (RFM) was stratified into subgroups with normal and poor perinatal outcomes.

Main Results:

• Fetuses with poor perinatal outcomes exhibited higher MPI and E/A ratios, and significantly lower f-TAPSE values.
• f-TAPSE was identified as the sole independent predictor of poor perinatal outcome in regression analysis (p=0.04).

Conclusions:

• Fetal echocardiographic evaluation, specifically f-TAPSE, can predict adverse perinatal outcomes in pregnancies complicated by RFM.
• f-TAPSE offers a clinically useful and easily obtainable measure of right ventricular function.
• Integrating f-TAPSE into clinical practice may improve risk stratification and timely intervention, potentially reducing stillbirth rates.