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Fetal isovolumetric time intervals as a marker of abnormal cardiac function in fetal anemia from homozygous alpha thalassemia‐1 disease
Author(s) -
Tongprasert Fuanglada,
Srisupundit Kasemsri,
Luewan Suchaya,
Traisrisilp Kuntharee,
Jatavan Phudit,
Tongsong Theera
Publication year - 2017
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.5140
Subject(s) - isovolumetric contraction , medicine , thalassemia , fetus , alpha thalassemia , fetal hemoglobin , anemia , cardiology , pregnancy , diastole , biology , biochemistry , gene , blood pressure , genotype , genetics
Objective To determine whether fetal isovolumetric time intervals can be an early sonographic marker of fetal anemia in fetuses with homozygous alpha thalassemia‐1. Methods Pregnancies at risk for fetal homozygous alpha thalassemia‐1 disease at 18–22 weeks were recruited before cordocentesis for hemoglobin typing. Isovolumetric contraction time (ICT) and isovolumetric relaxation time (IRT) intervals were measured by placing pulsed wave Doppler sample volume within the left ventricle to obtain the mitral and aortic waveform. Time intervals were compared between the affected group of homozygous alpha thalassemia‐1 fetuses and the unaffected group. Results Among 70 fetuses at risk, 28 cases were diagnosed as affected by homozygous alpha thalassemia‐1 disease. Mean ICT and ICT + IRT intervals in the affected group were significantly longer than in the unaffected group (47.9 ± 12.5 ms vs 35.0 ± 6.7 ms, p < 0.001; and 96.2 ± 13.6 ms vs 80.9 ± 10.6 ms, p < 0.001. ICT effectively predicted affected fetuses with 71.4% sensitivity and 78.6% specificity using a cutoff value ≥40 ms. Conclusions Isovolumetric contraction time was significantly prolonged in fetal anemia from homozygous alpha thalassemia‐1 during the early stage of hydropic changes. Because of its simple measurement and high efficacy, ICT can be a useful marker for prenatal screening of abnormal cardiac function in fetal anemia. © 2017 John Wiley & Sons, Ltd.