RESUMEN
Objective:To evaluate the systolic function of 24 segments in dichorionic diamniotic (DCDA) twin pregnancy by fetal heart qualification (fetal HQ) analysis, and to compare the difference with singleton pregnancies.Methods:Thirty-one cases of DCDA twin pregnancy (observation group) and 100 cases of singleton pregnancy (control group) matched in gestational age were enrolled. They underwent perinatal health care in the Third Affiliated Hospital of Zhengzhou University from February 2022 to February 2023.Fetal HQ was applied to track endocardial motion trajectories and automatically calculate the global strain (GS), fractional area change (FAC) and fractional shortening (FS) of 24 segments of left and right ventricles in order to compare the difference between DCDA fetuses and singleton fetuses. One case of twins with growth discordance were selected to demonstrate the utility of this technique.Results:①There were no statistically significant differences in GS, FAC and 24-segments FS of left and right ventricles between the two fetuses in the observation group (all P>0.05). ②The LV-FS of segments 1-10 were higher in the observation group than the control group, and the differences were statistically significant (all P<0.05). However, there were no statistically significant differences in GS and FAC of left and right ventricles, LV-FS of segments 11-24 and RV-FS of segments 1-24 between the observation group and the control group (all P>0.05). The intraclass correlation coefficient(ICC) was greater than 0.75, indicating good repeatability. ③Two fetuses with discordant growth in dichorionic diamniotic twins had abnormal FS in some segments of the left and right ventricles. Conclusions:Fetal HQ technology could easily and reliably evaluate fetal heart function in DCDA pregnancy with good repeatability. The changes of fetal cardiac function in twin pregnancy did not always follow the same pattern as in singleton pregnancy. The related data of singleton pregnancy should not be blindly used in the clinical management and scientific research of twin pregnancy.