Correlation Between Tricuspid Regurgitation and Fetal Cardiac Structure, Signs, and Chromosomal Abnormalities in Fetuses at 12 +0 to 16 +0 Weeks of Gestation

Abstract Objective This study aimed to investigate the correlation between tricuspid regurgitation (TR) in fetuses at 12+ 0 to 16+ 0 weeks of gestation and fetal cardiac structure, signs, and chromosomal abnormalities. Methods A prospective collection of dynamic four-chamber view (4CV) color Doppler ultrasound images of fetuses at 12+ 0 to 16+ 0 weeks of gestation was performed to screen for TR. The correlation between the non-TR and TR groups in fetal cardiac structure or signs and chromosomal abnormalities was analyzed, as well as the correlation between different grades of TR and fetal cardiac structure, signs, and chromosomal abnormalities. Results (1) In this study, 1018 early gestational fetuses were included, with a 100% detection rate of dynamic 4CV color Doppler ultrasound images. (2) Among the 1018 fetuses, 942 were in the non-TR group, and 76 were in the TR group, yielding a TR detection rate of 7.47% (76/1018). In the TR group, 62 cases were mild, 6 cases were moderate, and 8 cases were severe. Among the TR group, 64 fetuses had no cardiac structural or echocardiographic signs of abnormalities or chromosomal abnormalities, with a TR occurrence rate of about 6.39% (64/1002) in normal fetuses. The risk of cardiac structural or echocardiographic abnormalities in the TR group was 17 times higher than that in the non-TR group, and the risk of chromosomal abnormalities in the TR group was 25 times higher than that in the non-TR group. After refining the TR grade, the proportion of mild and severe abnormalities of TR in cardiac structure or signs and chromosomal abnormalities gradually increased. (3) In the early stages of pregnancy, we observed significant differences in the prevalence of hypertension and diabetes between the non-TR group and the TR group (P < 0.05). (4) In the early stages of pregnancy, there were no significant differences in cardiac structure or echocardiographic signs of abnormalities, nor in chromosomal abnormalities between the non-TR group and the mild TR group (P > 0.05). However, significant differences were observed in these abnormalities between the non-TR group and the following TR groups: moderate TR, severe TR, moderate + severe TR, and mild + moderate + severe TR (P < 0.05). (5) We found no significant difference between moderate TR and severe TR in cardiac structural or echocardiographic abnormalities and chromosomal abnormalities (P > 0.05). However, statistically significant differences were observed between mild TR and severe TR, as well as between mild TR and moderate + severe TR, in cardiac structural or echocardiographic abnormalities and chromosomal abnormalities (P < 0.05). Conclusion Grading TR in fetuses at 12+ 0 to 16+ 0 weeks can provide important clues for early screening of fetal cardiac structural or echocardiographic abnormalities and chromosomal abnormalities. This method offers reliable evidence for clinical practice and has high application value.