• Cerebroplacental ratio (CPR)
• Hemodynamic
• Maternal oxygenation inhalation
• Placental pulsatility index (PPI)
• Prenatal ultrasonography

• Humans
• Female
• Pregnancy
• Adult
• Retrospective Studies
• Hemodynamics/drug effects
• Oxygen Inhalation Therapy/methods
• Ultrasonography, Prenatal
• Oxygen/administration & dosage
• Pregnancy Trimester, Third
• Fetus/blood supply
• COVID-19/epidemiology
• Infant, Newborn

• No. 2021J011449 Natural Science Foundation of Fujian Province

• Fetal echocardiography
• Fetal heart quantification
• Growth restricted fetuses

• Humans
• Fetal Growth Retardation/diagnostic imaging
• Fetal Growth Retardation/physiopathology
• Female
• Pregnancy
• Fetal Heart/diagnostic imaging
• Fetal Heart/physiopathology
• Ultrasonography, Prenatal/methods
• Adult
• Middle Cerebral Artery/diagnostic imaging
• Middle Cerebral Artery/physiopathology
• Umbilical Arteries/diagnostic imaging
• Umbilical Arteries/physiopathology
• Case-Control Studies
• Gestational Age

• 2022YFC2704700 National Key Research and Development Program of China

• Fetal congenital heart disease
• cardiac function
• tissue Doppler
• two-dimensional speckle tracking imaging

• cardiac screening
• congenital heart disease
• fetal echocardiography
• first trimester

• Pregnancy
• Female
• Humans
• Pregnancy Trimester, First
• Ultrasonography, Prenatal/methods
• Prenatal Diagnosis/methods
• Echocardiography/methods
• Ultrasonography
• Heart Defects, Congenital/diagnostic imaging
• Fetal Heart/diagnostic imaging

• Fetal heart
• Reference values
• Spectral Doppler
• Systolic-to-diastolic duration ratio
• Tissue Doppler

To assess the mitral and tricuspid annular plane systolic excursions (MAPSE and TAPSE, respectively) and cardiac output (CO) in fetuses of pregnant women with pregestational diabetes mellitus (DM) using spatio-temporal image correlation M-mode (STIC-M) and virtual organ computer-aided analysis (VOCAL).

This study was prospective and cross-sectional. It included 45 fetuses each from mothers with pregestational DM and healthy mothers, with gestation ages ranging from 20 to 36.6 weeks. The fetal cardiac volumes were obtained and analyzed by STIC and VOCAL methods. MAPSE and TAPSE were measured by STIC-M in the apical or basal four-chamber view. The values of the right (RV) and left ventricular (LV) CO were calculated by STIC and VOCAL.

The median values of TAPSE were 6.1 and 6.2 mm in the diabetic and control groups (P<0.001), respectively. The median values of MAPSE were 4.6 mm in the fetuses of mothers with diabetes and 4.8 mm in fetuses of healthy mothers. The fetal LV CO (60.4 L/min vs. 71.1 L/min; P=0.033, respectively) and RV CO (65.2 vs. 70.1 L/min; P=0.026, respectively) were lower in the pregestational DM group than in the control group. A significant effect of pregestational DM was observed in all functional parameters after adjusting, with fetal heart rate as covariant. There was moderate significant positive correlation between MAPSE and LV CO (r=0.53; P=0.0001) and between TAPSE and RV CO (r=0.46; P=0.0001).

Significant difference in functional parameters (TAPSE, MAPSE and LV CO) obtained by STIC and VOCAL were observed in the fetuses of the pregestational DM group compared to those of the control group.

• Cardiac output
• Diabetes mellitus
• Fetal heart
• Four-dimensional echocardiography
• Systolic heart failure

• Diabetes mellitus
• Fetal cardiac function
• Spatio-temporal image correlation
• Three-dimensional ultrasound
• Virtual organ computer-aided analysis

• M-mode
• MAPSE
• SAPSE
• TAPSE
• fetal heart
• reference ranges

• Fetal heart
• Filling time
• Reference ranges
• Systolic-to-diastolic time interval

• M-mode
• fetal cardiac function
• fetal echocardiography
• mitral annular plane systolic excursion
• pregnancy
• tricuspid annular plane systolic excursion

• Adult
• Australia
• Bayes Theorem
• Echocardiography/methods
• Female
• Humans
• Longitudinal Studies
• Mitral Valve/anatomy & histology
• Mitral Valve/embryology
• Pregnancy
• Prospective Studies
• Reference Values
• Tricuspid Valve/anatomy & histology
• Tricuspid Valve/embryology
• Ultrasonography, Prenatal/methods

Three- and four-dimensional (3D/4D) ultrasonography with spatio-temporal image correlation (4D-STIC) allows obtaining fetal cardiac volumes and their static and real-time analysis in multiplanar and rendering modes. Cardiac biometrics and Doppler-echocardiographic parameters for evaluation of fetal heart function, including cardiac output and stroke volume, can be analyzed using M-mode, two-dimensional (2D), and 3D/4D cardiac ultrasound. In recent years, functional echocardiography has been used to study fetuses without a structurally cardiac defect but who are at risk of heart failure due to the presence of extra-cardiac conditions, such as, fetal growth restriction, tumors/masses, twin-to-twin transfusion syndrome, fetal anemia (Rh alloimmunization), congenital infections, or maternal diabetes mellitus. The assessment of cardiac function provides important information on hemodynamic status and can help optimize the best time for delivery and reduce perinatal morbidity and mortality. Since 2003, with the advent of the 4D-STIC software, it is possible to evaluate the fetal heart in multiplanar, and rendering modes. This technology associated with virtual organ computer-aided analysis (VOCAL) enables determining the ventricular volume (end-diastole, end-systole), the stroke-volume, the ejection fraction, and the cardiac output of each ventricle. Since 2004, several studies demonstrated that the 4D-STIC and VOCAL had good reproducibility to measure cardiac volumes This study reviews published studies that evaluated the fetal cardiac function by 3D ultrasound using 4D-STIC and VOCAL software.

• cardiac function
• fetal heart
• spatio-temporal image correlation
• three-dimensional ultrasound
• virtual organ computer-aided analysis

Heart defects are the most common congenital malformations in fetuses. Fetal cardiac structure and function abnormalities lead to changes in ventricular volume. As ventricular volume is an important index for evaluating fetal cardiovascular development, an effective and reliable method for measuring fetal ventricular volume and cardiac function is necessary for accurate ultrasonic diagnosis and effective clinical treatment. The new intelligent spatiotemporal image correlation (iSTIC) technology acquires high-resolution volumetric images. In this study, the iSTIC technique was used to measure right ventricular volume and to evaluate right ventricular systolic function to provide a more accurate and convenient evaluation of fetal heart function.

To investigate the value of iSTIC in evaluating right ventricular volume and systolic function in normal fetuses.

Between October 2014 and September 2015, a total of 123 pregnant women received prenatal ultrasound examinations in our hospital. iSTIC technology was used to acquire the entire fetal cardiac volume with off-line analysis using QLAB software. Cardiac systolic and diastolic phases were defined by opening of the atrioventricular valve and the subsequent closure of the atrioventricular valve. The volumetric data of the two phases were measured by manual tracking and summation of multiple slices and recording of the right ventricular end-systolic volume and the right ventricular end-diastolic volume. The data were used to calculate the right stroke volume, the right cardiac output, and the right ejection fraction. The correlations of changes between the above-mentioned indices and gestational age were analyzed. The right ventricular volumes of 30 randomly selected cases were measured twice by the same sonographer, and the intra-observer agreement measurements were calculated.

Among the 123 normal fetuses, the mean right ventricular end-diastolic volume increased from 0.99 ± 0.34 mL at 22 wk gestation to 3.69 ± 0.36 mL at 35⁺⁶ wk gestation. The mean right ventricular end-systolic volume increased from 0.43 ± 0.18 mL at 22 wk gestation to 1.36 ± 0.22 mL at 35⁺⁶ wk gestation. The mean right stroke volume increased from 0.62 ± 0.29 mL at 22 wk gestation to 2.33 ± 0.18 mL at 35⁺⁶ wk gestation. The mean right cardiac output increased from 92.23 ± 40.67 mL/min at 22 wk gestation to 335.83 ± 32.75 mL/min at 35⁺⁶ wk gestation. Right ventricular end-diastolic volume, right ventricular end-systolic volume, right stroke volume, and right cardiac output all increased with gestational age and the correlations were linear (P < 0.01). Right ejection fraction had no apparent correlation with gestational age (P > 0.05).

Fetal right ventricular volume can be quantitatively measured using iSTIC technology with relative ease and high repeatability. iSTIC technology is expected to provide a new method for clinical evaluation of fetal cardiac function.

• Ultrasonography
• Fetus
• Intelligent spatiotemporal image correlation
• Right ventricular volume
• Cardiac function

• cardiac malformation
• clinical classification
• diagnostic value
• fetus
• four-dimensional echocardiography
• two-dimensional echocardiography

• Atrioventricular peak velocities
• fetal heart
• myocardial performance index
• reference ranges

The purpose of this pictorial review was to describe various echocardiographic techniques that can be used for the functional assessment of the fetal heart. The systolic and diastolic assessments of the fetal heart are presented separately, with an emphasis on 2-dimensional Doppler methods and an overview of new technologies. The aim of this summary was to review the tools that can be used by the echocardiographer, and on that basis, to systematize the process of performing a functional assessment.

• Color Doppler
• Echocardiography
• Fetal heart
• Function

• Color Doppler
• Z-scores
• echocardiography
• fetal heart
• function