Diagnostic value of prenatal ultrasound parameters combined with serum apolipoprotein C1 and lamin A levels in the detection of fetal cardiac structural abnormalities and chromosomal abnormalities

Background/Aim. Early screening for fetal cardiac structural abnormality (CSA) is crucial for improving prenatal outcomes. The aim of the study was to evaluate the diagnostic value of prenatal ultrasound parameters, combined with serum apolipoprotein C1 (APOC1) and lamin A (LMNA) levels, for detecting fetal CSA and chromosomal abnormality (CA). Methods. The research included 146 pregnant women (PW) admitted from July 2022 to March 2024, who were divided into two groups. The study group comprised 86 PW with a fetal CSA diagnosis, while the control group consisted of 60 PW with normal fetal cardiac structures who underwent prenatal examination during the same period. Results. Patients in the study group had lower ventricular systolic velocity (S), ventricular diastolic velocity (D), atrial systolic velocity (A), maximum A-wave velocity ( \mathrm{TA_{max}} ), and serum LMNA levels, alongside a higher pulsatility index (PI) and serum APOC1 levels compared to the control group (p < 0.001). Serum APOC1 levels were negatively correlated with S, D, A, and ( \mathrm{TA_{max}} )(r < 0, p < 0.001) but positively correlated with PI (r > 0, p < 0.001). Conversely, serum LMNA levels were positively correlated with S, D, A, and ( \mathrm{TA_{max}} )(r > 0, p < 0.001), and negatively correlated with PI (r < 0, p < 0.001). For the diagnosis of CA, the areas under the curve - AUCs for S, D, A, ( \mathrm{TA_{max}} ), PI, serum APOC1, and serum LMNA levels alone, as well as the combination of all indicators reached, were 0.750, 0.817, 0.823, 0.802, 0.835, 0.796, 0.831, and 0.911, respectively. Conclusion. In the serum of PW carrying a fetus with CSA and CA, APOC1 levels were elevated, whereas LMNA levels were reduced. Combining prenatal ultrasound parameters with serum APOC1 and LMNA levels yields a significantly higher diagnostic value, which could be used for the early screening of high-risk pregnancies.