Abstract
The study focused on the application value of ultrasound Doppler fetal heart rate detection algorithm based on short-time Fourier transform (STFT) in the diagnosis of twin-to-twin selective intrauterine growth restriction (sIUGR) and the correlation between twin-to-twin sIUGR and sFas/sFasL levels of umbilical cord blood. The normalized method was introduced into the STFT algorithm to optimize it to detect the fetal instantaneous heart rate. 82 pregnant women with twin pregnancies were selected as the research subjects and they were divided into the restricted group (41 cases) and the control group (41 cases) according to whether the fetus had selective growth restriction. The two groups were compared for the differences in the fetal mortality, complication rate, and sFas/sFasL expression levels. The results showed that the STFT-based ultrasonic Doppler fetal heart rate detection algorithm could ensure the quality of the fetal heart rate signal and had high resolution at the 200–400 Hz characteristic frequency band and that the accuracy in distinguishing S1 and S2 was 5.8% higher than that of the traditional autocorrelation algorithm. The proportion of abnormal fetal heart rate in the restricted group was significantly higher than that in the control group ( P < 0.05 ), birth weight was significantly lower than that in the control group ( P < 0.05 ), and fetal mortality was significantly higher than that in the control group ( P < 0.05 ). There was no statistical difference in the incidence of complications between the two groups ( P > 0.05 ). In restricted group, the content of sFas in cord blood was (3326.54 ± 317.42) pg/mL and that in the control group was (2003.29 ± 196.45) pg/mL. The content of sFas in cord blood of the restricted group was significantly higher than that of the control group ( P < 0.01 ). In the restricted group, the content of sFasL in cord blood was (382.52 ± 36.17) pg/mL, and that in the control group was (180.84 ± 16.20) pg/mL. The content of sFasL in cord blood of the restricted group was significantly higher than that of the control group ( P < 0.001 ). It was concluded that the STFT-based ultrasound Doppler fetal heart rate monitoring is beneficial to early diagnosis and timely intervention of twin-to-twin sIUGR.
Highlights
With the continuous development of assisted reproductive technology, the incidence of twin-to-twin pregnancy has shown a significant upward trend, from 1/80 of natural pregnancy to about 20% [1]. e intrauterine growth environment of twin-to-twin pregnancy is more complicated than a single pregnancy, and the incidence of premature delivery, intrauterine growth restriction, perinatal mortality, and congenital turbulence is significantly increased [2]
Fetal growth restriction (FGR) has a certain impact on fetal development and later physical and intellectual development, and its perinatal mortality rate is about 5 times that of normal fetuses [4], so it is of great significance to explore the pathogenesis of FGR. ere are many and complex causes of FGR. e Fas/FasL system is mainly responsible for inducing cell apoptosis. e current research results show that Fas and FasL are expressed in placental trophoblasts and decidua cells of full-term parturients
Fetal growth restriction is one of the important complications in the perinatal period. selective intrauterine growth restriction (sIUGR) can occur at any period of pregnancy and is one of the common complications in twin-to-twin pregnancy, mostly caused by congenital abnormalities. e results of this study found that the birth weight of the fetus in the restricted group was significantly lower than that in the control group (P < 0.05), indicating that the weight of the fetus in the restricted group was reduced
Summary
With the continuous development of assisted reproductive technology, the incidence of twin-to-twin pregnancy has shown a significant upward trend, from 1/80 of natural pregnancy to about 20% [1]. e intrauterine growth environment of twin-to-twin pregnancy is more complicated than a single pregnancy, and the incidence of premature delivery, intrauterine growth restriction, perinatal mortality, and congenital turbulence is significantly increased [2]. E intrauterine growth environment of twin-to-twin pregnancy is more complicated than a single pregnancy, and the incidence of premature delivery, intrauterine growth restriction, perinatal mortality, and congenital turbulence is significantly increased [2]. Fetal growth restriction (FGR) is one of the important complications of the perinatal period, with an incidence rate of 2.75%∼15.53%, and the domestic average FGR incidence rate is 6.39% [3]. FGR has a certain impact on fetal development and later physical and intellectual development, and its perinatal mortality rate is about 5 times that of normal fetuses [4], so it is of great significance to explore the pathogenesis of FGR. Studies have analyzed the Fas/FasL expression in the placenta of FGR patients and normal pregnant women. There are few studies on the correlation between Fas/FasL and twin-to-twin selective intrauterine growth restriction (sIUGR)
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