
A new study out of China, published in the European Journal of Obstetrics & Gynecology and Reproductive Biology, suggests that performing an echocardiogram during the third trimester of pregnancy could lead to early detection of persistent pulmonary hypertension of the newborn (PPHN).
In utero, a fetus receives oxygen through the umbilical cord. Upon birth, the cord is clamped, and a newborn must rapidly switch to pulmonary gas exchange. If this does not occur and the newborn’s pulmonary arteries don’t open widely enough to limit oxygen and blood flow, then he or she will be diagnosed with PPHN.
An echocardiogram is a non-invasive test that uses sound waves to measure heart function and diagnose pulmonary hypertension (PH). Using pulmonary artery stiffness (PAS) as an important indicator for PH has long been considered the “gold standard” when identifying the condition in infants and adults. However, the efficacy of using an echocardiogram during pregnancy to predict the risk of PH in fetuses has not been measured previously.
Study results demonstrated that a PAS cutoff value of 37.40 KHz/s indicated PH at an accuracy of 92.3%, a sensitivity of 100% and a specificity of 91.5%. These findings are an significant first step in in validating the new approach, which would lead to earlier diagnosis and treatment.
Scientists from Tongji University in Shanghai performed the study by analyzing data from pregnant people who were patients at their maternal-fetal medical center between July 2017 and January 2023. They reviewed echocardiogram data conducted during second and third trimesters, as well as within 14 days post-birth, for a total of 1,325 fetuses. Of these, six fetuses, or newborns, were diagnosed with PPHN—an incidence rate of 4.53 per 1,000 live births.
Next, research teams will need to complete additional studies with a larger, diverse population base.