Evaluation of fetal heart quantification analysis in healthy pregnancies across gestational weeks. A prospective observational study

Fetal Heart Quantification is a technology based on two-dimensional speckle-tracking imaging, which divides the fetal ventricle into 24 segments. It is used to quantitatively analyze and evaluate fetal heart morphology and function.

A prospective observational study was conducted among 52 healthy pregnant women between 18 and 22 weeks of gestation. The Fetal Heart Quantification technology was used to collect ultrasound images for studying fetal heart structure and function. The images were enhanced to define the boundary between the blood and the endocardium. Four-chamber images were recorded as 3-second clips in Digital Imaging and Communications in Medicine files and stored. Measurements of the right and left ventricles and the differences between the 24 segment measurements were recorded and evaluated. SPSS 26.0 was used to analyze variables. The Kolmogorov-Smirnov test was used to assess the normality of the data distribution. The Bootstrap and Monte Carlo simulation techniques were used to assess the robustness of the findings. Paired-samples T-test and Wilcoxon Signed-Rank test were used to compare dependent quantitative variables as appropriate. Partial correlation tests were conducted to determine the correlation between these variables. The variables were analyzed at a 95% confidence level, and a p-value of less than 0.05 was considered statistically significant.

Significant differences between the right and left ventricles were observed for fractional area change (FAC), ventricle end-diastolic volume (EDV) area, ventricle end-systolic volume (ESV) area and length (p<0.05). There was no noticeable difference in the sphericity index values. Left ventricular 24-segment transverse fractional shortening (FS) was significantly greater than right ventricular FS at segments 1 and 23 (p<0.05). The ESV and cardiac output were positively correlated with estimated fetal weight, while cardiac output was positively correlated with ventricular EDV length (p<0.05). There were no significant relationships between the shape of ventricles, short axis shortening, or EDV and gestational age or Estimated Fetal Weight (p>0.05).

Fetal Heart Quantification is a quantitative method for assessing fetal ventricular morphology and function during a healthy pregnancy. More extensive and comprehensive studies, as well as meta-analyses involving different ethnic groups, are needed to standardize fetal HQ analyses for both healthy fetuses and those in complicated pregnancies, and to establish their diagnostic value.