Automated quantitative evaluation of fetal atrioventricular annular plane systolic excursion before and after intrauterine blood transfusion in pregnancies affected by red blood cell alloimmunization
Abstract Introduction Maternal red blood cell alloimmunization during pregnancy can lead to hemolysis and various degrees of fetal anemia, which can be treated with intrauterine blood transfusion (IUT) to prevent adverse outcomes. Knowledge about fetal myocardial function and adaptation is limited....
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-02-01
|
| Series: | Acta Obstetricia et Gynecologica Scandinavica |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/aogs.14722 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849687249765007360 |
|---|---|
| author | Aikaterini Zamprakou Ingrid Söderhult Kjerstin Ferm‐Widlund Gunilla Ajne Jonas Johnson Lotta Herling |
| author_facet | Aikaterini Zamprakou Ingrid Söderhult Kjerstin Ferm‐Widlund Gunilla Ajne Jonas Johnson Lotta Herling |
| author_sort | Aikaterini Zamprakou |
| collection | DOAJ |
| description | Abstract Introduction Maternal red blood cell alloimmunization during pregnancy can lead to hemolysis and various degrees of fetal anemia, which can be treated with intrauterine blood transfusion (IUT) to prevent adverse outcomes. Knowledge about fetal myocardial function and adaptation is limited. The aim of the present study was to measure fetal atrioventricular plane displacement before and after IUT and compare these measurements with previously established reference ranges. Material and methods An observational study was conducted on pregnant women affected by red blood cell alloimmunization. Fetal echocardiography was performed before and after IUT. The atrioventricular plane displacement of the left and right ventricular walls and interventricular septum, described as mitral, septal, and tricuspid annular plane systolic excursion (MAPSE, SAPSE, and TAPSE, respectively), was assessed using color tissue Doppler imaging with automated analysis software. A Mann–Whitney U test was used to compare the z scores to the normal mean before and after IUT. Results Twenty‐seven fetuses were included. The mean z score for pre‐IUT MAPSE was significantly increased compared with the reference ranges, +0.46 (95% confidence interval [CI] +0.17 to +0.75; p = 0.039), while the mean z scores for post‐IUT SAPSE and TAPSE were significantly decreased, −0.65 (95% CI −1.11 to −0.19; p < 0.001) and −0.60 (95% CI −1.04 to −0.17; p = 0.003), respectively. The difference in atrioventricular plane displacement z scores before and after IUT was statistically significant in all three locations. The median difference between the pre‐IUT and post‐IUT z scores was −0.66 (95% CI −1.03 to −0.33, p < 0.001) for MAPSE, −1.05 (95% CI −1.43 to −0.61, p < 0.001) for SAPSE, and −0.60 (95% CI −1.19 to −0.01, p = 0.046) for TAPSE. Conclusions This study suggests that atrioventricular plane displacement, when determined using automated analysis software, may represent a quantitative parameter, describing fetal myocardial function and adaptation before and after IUT. |
| format | Article |
| id | doaj-art-6663010e9e5045d3a01d02c720f45ca7 |
| institution | DOAJ |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2024-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-6663010e9e5045d3a01d02c720f45ca72025-08-20T03:22:22ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122024-02-01103231332110.1111/aogs.14722Automated quantitative evaluation of fetal atrioventricular annular plane systolic excursion before and after intrauterine blood transfusion in pregnancies affected by red blood cell alloimmunizationAikaterini Zamprakou0Ingrid Söderhult1Kjerstin Ferm‐Widlund2Gunilla Ajne3Jonas Johnson4Lotta Herling5Center for Fetal Medicine, Pregnancy Care and Delivery Karolinska University Hospital Stockholm SwedenCenter for Fetal Medicine, Pregnancy Care and Delivery Karolinska University Hospital Stockholm SwedenCenter for Fetal Medicine, Pregnancy Care and Delivery Karolinska University Hospital Stockholm SwedenDivision of Obstetrics and Gynecology, Department of Clinical Sciences, Intervention and Technology (CLINTEC) Karolinska Institutet Stockholm SwedenCenter for Fetal Medicine, Pregnancy Care and Delivery Karolinska University Hospital Stockholm SwedenCenter for Fetal Medicine, Pregnancy Care and Delivery Karolinska University Hospital Stockholm SwedenAbstract Introduction Maternal red blood cell alloimmunization during pregnancy can lead to hemolysis and various degrees of fetal anemia, which can be treated with intrauterine blood transfusion (IUT) to prevent adverse outcomes. Knowledge about fetal myocardial function and adaptation is limited. The aim of the present study was to measure fetal atrioventricular plane displacement before and after IUT and compare these measurements with previously established reference ranges. Material and methods An observational study was conducted on pregnant women affected by red blood cell alloimmunization. Fetal echocardiography was performed before and after IUT. The atrioventricular plane displacement of the left and right ventricular walls and interventricular septum, described as mitral, septal, and tricuspid annular plane systolic excursion (MAPSE, SAPSE, and TAPSE, respectively), was assessed using color tissue Doppler imaging with automated analysis software. A Mann–Whitney U test was used to compare the z scores to the normal mean before and after IUT. Results Twenty‐seven fetuses were included. The mean z score for pre‐IUT MAPSE was significantly increased compared with the reference ranges, +0.46 (95% confidence interval [CI] +0.17 to +0.75; p = 0.039), while the mean z scores for post‐IUT SAPSE and TAPSE were significantly decreased, −0.65 (95% CI −1.11 to −0.19; p < 0.001) and −0.60 (95% CI −1.04 to −0.17; p = 0.003), respectively. The difference in atrioventricular plane displacement z scores before and after IUT was statistically significant in all three locations. The median difference between the pre‐IUT and post‐IUT z scores was −0.66 (95% CI −1.03 to −0.33, p < 0.001) for MAPSE, −1.05 (95% CI −1.43 to −0.61, p < 0.001) for SAPSE, and −0.60 (95% CI −1.19 to −0.01, p = 0.046) for TAPSE. Conclusions This study suggests that atrioventricular plane displacement, when determined using automated analysis software, may represent a quantitative parameter, describing fetal myocardial function and adaptation before and after IUT.https://doi.org/10.1111/aogs.14722annular plane systolic excursionatrioventricular plane displacementautomated analysisfetal anemiafetal cardiac functionintrauterine blood transfusion |
| spellingShingle | Aikaterini Zamprakou Ingrid Söderhult Kjerstin Ferm‐Widlund Gunilla Ajne Jonas Johnson Lotta Herling Automated quantitative evaluation of fetal atrioventricular annular plane systolic excursion before and after intrauterine blood transfusion in pregnancies affected by red blood cell alloimmunization Acta Obstetricia et Gynecologica Scandinavica annular plane systolic excursion atrioventricular plane displacement automated analysis fetal anemia fetal cardiac function intrauterine blood transfusion |
| title | Automated quantitative evaluation of fetal atrioventricular annular plane systolic excursion before and after intrauterine blood transfusion in pregnancies affected by red blood cell alloimmunization |
| title_full | Automated quantitative evaluation of fetal atrioventricular annular plane systolic excursion before and after intrauterine blood transfusion in pregnancies affected by red blood cell alloimmunization |
| title_fullStr | Automated quantitative evaluation of fetal atrioventricular annular plane systolic excursion before and after intrauterine blood transfusion in pregnancies affected by red blood cell alloimmunization |
| title_full_unstemmed | Automated quantitative evaluation of fetal atrioventricular annular plane systolic excursion before and after intrauterine blood transfusion in pregnancies affected by red blood cell alloimmunization |
| title_short | Automated quantitative evaluation of fetal atrioventricular annular plane systolic excursion before and after intrauterine blood transfusion in pregnancies affected by red blood cell alloimmunization |
| title_sort | automated quantitative evaluation of fetal atrioventricular annular plane systolic excursion before and after intrauterine blood transfusion in pregnancies affected by red blood cell alloimmunization |
| topic | annular plane systolic excursion atrioventricular plane displacement automated analysis fetal anemia fetal cardiac function intrauterine blood transfusion |
| url | https://doi.org/10.1111/aogs.14722 |
| work_keys_str_mv | AT aikaterinizamprakou automatedquantitativeevaluationoffetalatrioventricularannularplanesystolicexcursionbeforeandafterintrauterinebloodtransfusioninpregnanciesaffectedbyredbloodcellalloimmunization AT ingridsoderhult automatedquantitativeevaluationoffetalatrioventricularannularplanesystolicexcursionbeforeandafterintrauterinebloodtransfusioninpregnanciesaffectedbyredbloodcellalloimmunization AT kjerstinfermwidlund automatedquantitativeevaluationoffetalatrioventricularannularplanesystolicexcursionbeforeandafterintrauterinebloodtransfusioninpregnanciesaffectedbyredbloodcellalloimmunization AT gunillaajne automatedquantitativeevaluationoffetalatrioventricularannularplanesystolicexcursionbeforeandafterintrauterinebloodtransfusioninpregnanciesaffectedbyredbloodcellalloimmunization AT jonasjohnson automatedquantitativeevaluationoffetalatrioventricularannularplanesystolicexcursionbeforeandafterintrauterinebloodtransfusioninpregnanciesaffectedbyredbloodcellalloimmunization AT lottaherling automatedquantitativeevaluationoffetalatrioventricularannularplanesystolicexcursionbeforeandafterintrauterinebloodtransfusioninpregnanciesaffectedbyredbloodcellalloimmunization |