Mid-gestation 2D-STE detects early fetal cardiac deformation alterations in pregnancies later complicated by preeclampsia, fetal growth restriction, and gestational diabetes.
Does two-dimensional speckle-tracking echocardiography detect early alterations in fetal cardiac function at mid-gestation in pregnancies that subsequently develop preeclampsia, fetal growth restriction, or gestational diabetes mellitus?
This review synthesizes evidence on the use of 2D-STE at mid-gestation to detect early fetal cardiovascular programming in complicated pregnancies.
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Preeclampsia (PE), fetal growth restriction (FGR), and gestational diabetes mellitus (GDM) complicate approximately 15–20% of pregnancies and represent major contributors to perinatal morbidity, mortality, and long-term cardiovascular risk in offspring. Increasing evidence from longitudinal cohort studies indicates that adult cardiovascular disease, including hypertension, coronary artery disease, and stroke, may be programmed in utero through early alterations in fetal cardiac structure and function. Two-dimensional speckle-tracking echocardiography (2D-STE) has emerged as the most sensitive non-invasive technique for detecting subclinical myocardial deformation, often preceding abnormalities detected by conventional Doppler or biometric parameters. While numerous third-trimester studies have demonstrated impaired global longitudinal strain (GLS), altered ventricular geometry, and diastolic dysfunction in established disease, data from mid-gestation (18–28 weeks), the critical preclinical window, remain extremely limited. Therefore, this review aims to systematically synthesize the available evidence on fetal cardiac deformation parameters assessed by 2D-STE at mid-gestation in pregnancies that subsequently developed PE, FGR, or GDM, in order to identify the earliest detectable signatures of fetal cardiovascular programming and highlight key knowledge gaps that must be addressed prior to clinical implementation.
Huluță et al. (Sat,) reported a other. Mid-gestation 2D-STE detects early fetal cardiac deformation alterations in pregnancies later complicated by preeclampsia, fetal growth restriction, and gestational diabetes.