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Oral Concurrent Session 9 - Fetal US Genetics

Oral Concurrent Sessions

(88) An assessment of the relation between first trimester fetal cardiac function and subsequent preeclampsia

Wednesday, February 14, 2024

3:45 PM – 4:00 PM

Location: Potomac Ballroom D, Ballroom Level

Primary & Presenting Author(s)

RH

Rebecca Horgan, MBBCH

MFM Fellow
Eastern Virginia Medical School
Norfolk, VA, United States

Coauthor(s)

George R. Saade, MD (he/him/his)

Professor & Chair of Ob-Gyn
Eastern Virginia Medical School
Norfolk, VA, United States
Alfred Abuhamad, MD

President, Provost and Dean
Eastern Virginia Medical School
Norfolk, VA, United States

Disclosure(s): Diagnoly: Consulting Fees (e.g., advisory boards) (Ongoing); Pulsenmore: Consulting Fees (e.g., advisory boards) (Ongoing); Sonosim: Consulting Fees (e.g., advisory boards) (Ongoing); Trice Imaging: Consulting Fees (e.g., advisory boards) (Ongoing)
EK

Erkan Kalafat, MD, MS

Koc University School of Medicine
Istanbul, Istanbul, Turkey
Elena Sinkovskaya, RDMS,MD,PhD,RDCS

Professor of Obstetrics and Gynecology and Director of Ultrasound Research and Education
Eastern Virginia Medical School
Norfolk, Virginia, United States

Objective: To compare fetal first trimester right ventricular (RV) cardiac function in uncomplicated pregnancies and in pregnancies who subsequently develop preeclampsia.

Study Design: This prospective longitudinal cohort study on the Human Placenta Project (HD 086313-01) included 610 pregnancies at < 13+6 weeks’ gestation without fetal, umbilical cord or placental abnormalities. At the first trimester ultrasound, the fetal RV Tei index was measured. The Tei index is a noninvasive Doppler index of combined systolic and diastolic function, calculated by isovolumic contraction time divided by ejection time. Study subjects were followed for the reminder of pregnancy and outcomes were evaluated by trained and certified research coordinators.Patients who ultimately developed preeclampsia (cases) were compared to those who had low risk pregnancies with normal outcomes (controls: aged 18-35 years, with a body mass index (BMI) < 30, without existing comorbidities, who conceived spontaneously and had an uncomplicated pregnancy, with delivery >37 weeks’ gestation). We compared fetal RV Tei index measurements on first trimester ultrasound between cases and controls.

Results: Amongst the 610 included pregnancies, 60 patients (9.8%) developed preeclampsia (n=60) and 90 patients were in the control group. Mean RV Tei index in the first trimester was significantly lower in cases versus controls (0.42 vs 0.49, p=0.025). Multinominal logistic regression tests were used for statistical analysis, with p < 0.05 used to denote statistical significance (R for Statistical Computing v.4.2.0).

Conclusion: Compared with normal patients, fetuses of patients who ultimately develop preeclampsia show changes in cardiac function early in pregnancy. We speculate that this represents early fetal adaptation to the previously described utero-placental-fetal vascular perturbation that precedes preeclampsia.