FETAL CARDIAC FUNCTION parameters were significantly altered in women with severe preeclampsia, according to a prospective observational study of 224 women diagnosed with the condition.
Researchers found that measures of myocardial performance and fetal Doppler indices differed markedly between severe and non-severe disease and were also associated with worse neonatal outcomes.
The study included 150 women with non-severe preeclampsia and 74 with severe preeclampsia.
Fetal cardiovascular assessment evaluated the Tei index, isovolumetric contraction time, isovolumetric relaxation time, ejection time, umbilical artery pulsatility index, pulmonary artery pulsatility index, and pulmonary artery peak systolic velocity.
Compared with the non-severe group, women with severe preeclampsia had significantly higher Tei index values (0.55 versus 0.48).
Severe disease was also associated with longer isovolumetric contraction time, longer isovolumetric relaxation time, higher umbilical artery pulsatility index, and higher pulmonary artery pulsatility index, while ejection time and pulmonary artery peak systolic velocity were lower.
These associations remained significant after adjustment for gestational age at assessment, maternal age, and body mass index, and persisted in sensitivity analyses that accounted for early onset preeclampsia and fetal growth restriction.
Exploratory receiver operating characteristic analyses suggested that isovolumetric relaxation time showed the strongest discrimination for severe preeclampsia. The Tei index also demonstrated strong discrimination.
Women with severe preeclampsia delivered earlier and had infants with lower birth weight and lower 5-minute Apgar scores than those with non-severe disease.
Neonatal intensive care unit admission was also more common in the severe group, occurring in 23.0% of cases compared with 5.3% among women with non-severe preeclampsia.
Although fetal cardiac function measures showed good discrimination for severe preeclampsia, performance for predicting neonatal intensive care unit admission was limited.
The Tei index achieved the highest area under the curve for neonatal intensive care unit admission at 0.650.
The investigators concluded that severe preeclampsia was associated with distinct changes in fetal cardiac function and Doppler parameters.
However, they emphasised that the findings were observational and that the receiver operating characteristic analyses were exploratory.
Further multicentre studies and validation work are needed to determine the reproducibility and potential clinical relevance of these measures.
Reference
Yılmaz EBS et al. Fetal cardiac function and doppler parameters in relation to preeclampsia severity and neonatal outcomes. Sci Rep. 2026;DOI:10.1038/s41598-026-73236-w.
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