Assessment of fetal myocardial performance index in women with pregestational and gestational diabetes mellitus

Sanhal, Cem Yaşar; Dağlar, Halil Korkut; Kara, Özgür; Uygur, Dilek; Yücel, Aykan

doi:10.1111/jog.13174

Cited by 48 publications

(61 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other studies suggested that the MPA index has a more stable pattern with advancing gestation . Fetuses of diabetic mothers usually have a higher value for the MPI at all trimesters compared to controls . Although these results support impairment in both systolic and diastolic components of cardiac cycle in fetuses of diabetic mothers, some studies could not reveal any changes in the MPI index or E/A ratio in fetuses of diabetic mothers …”

Section: Functional Evaluationmentioning

confidence: 77%

“…This may be attributed to the already lower E/A ratio that exists in fetuses of diabetic mothers at early gestation, as supported by studies evaluating the E/A ratio in the first trimester . Many other studies have also found a lower E/A ratio in fetuses of diabetic mothers compared with those of nondiabetic mothers in the second and third trimesters . At the same time, the E/A ratio can be measured lower in fetuses of diabetic mother compared to healthy controls even if blood glucose level is well regulated .…”

Section: Functional Evaluationmentioning

confidence: 82%

“…Some studies claimed that MPI could be used as a predictive marker for adverse perinatal outcomes in fetuses of diabetic women . Sanhal et al . reported that the cutoff for MPI in the left ventricle in the third trimester was calculated as 0.39 with a sensitivity of 91% and specificity of 48% in predicting perinatal adverse outcomes.…”

Section: Functional Evaluationmentioning

confidence: 90%

“…Some studies claimed that MPI could be used as a predictive marker for adverse perinatal outcomes in fetuses of diabetic women . Sanhal et al .…”

Section: Functional Evaluationmentioning

confidence: 99%

See 3 more Smart Citations

Exposure of the developing heart to diabetic environment and early cardiac assessment: A review

et al. 2018

View full text Add to dashboard Cite

Hyperglycemia during organogenesis is associated with an increased risk of congenital cardiac defects (CHDs). The pathophysiology leading to CHDs is not completely uncovered. However, elevated oxidative stress is considered to be the primary trigger that causes CHDs in fetuses of diabetic mothers. Maternal diabetes has been found to increase the risk for all types of CHDs. Diabetes may also impact the fetal cardiac performance at all gestational ages. Early detection of CHDs has certain advantages, such as making early decision about termination of pregnancy, enabling early genetic testing, and early reassurance if scan is normal. Combined transabdominal and transvaginal approach at 13-14 weeks of gestation is a reasonable strategy to assess fetal heart in diabetic women. Diagnostic accuracy of early fetal echocardiography has reached to above a reasonable cutoff when it is done in the late first trimester or early second trimester in the hands of expert sonographers. However, the literature is less certain to provide a firm conclusion about functional heart assessment in fetuses of diabetic mothers.

show abstract

Section: Functional Evaluationmentioning

confidence: 77%

Section: Functional Evaluationmentioning

confidence: 82%

Section: Functional Evaluationmentioning

confidence: 90%

“…Some studies claimed that MPI could be used as a predictive marker for adverse perinatal outcomes in fetuses of diabetic women . Sanhal et al .…”

Section: Functional Evaluationmentioning

confidence: 99%

See 2 more Smart Citations

Exposure of the developing heart to diabetic environment and early cardiac assessment: A review

et al. 2018

View full text Add to dashboard Cite

show abstract

“…MPI levels are expected to change in the presence of pathological conditions that influence fetal cardiac functions. These include fetal growth restriction (FGR), twin‐twin transfusion syndrome, maternal diabetes mellitus, preeclampsia, fetal hydrops, and fetal anemia . When fetal cardiac functions influence the MPI, it may be important to decide the time of the birth.…”

Section: Introductionmentioning

confidence: 99%

Utility of the modified myocardial performance index in growth‐restricted fetuses

et al. 2019

View full text Add to dashboard Cite

Objectives The modified myocardial performance index (Mod‐MPI) can be used to assess myocardial function. Fetal growth restriction can affect fetal myocardial function, thereby altering the Mod‐MPI. The results of previous studies on the utility of the Mod‐MPI in growth‐restricted fetuses are conflicting. The aim of this study was to calculate the left modified‐MPI in growth‐restricted fetuses and to compare the results with those of healthy fetuses. Methods This was a prospective cross‐sectional case–control study. In total, 40 women with growth‐restricted fetuses and 40 women with fetuses of normal weight (controls) at 29–39 gestational weeks were enrolled in the study. An experienced obstetrician calculated the Mod‐MPI for each fetus. Women with systemic diseases or fetuses with chromosomal/structural abnormalities were excluded from the study. The results of Mod‐MPI measurements of the two groups were compared. Results The mean single deepest vertical pocket (SDVP) of amniotic fluid, estimated fetal weight (EFW), and isovolumetric relaxation time (IRT) was significantly lower in the fetal growth restriction (FGR) group as compared with these parameters in the control group (P < .05). The uterine artery (UtA) pulsatility index (PI) was significantly higher in the FGR group as compared with that in the control group (P < .05). There were six cases of absent end‐diastolic flow (AED) in the FGR group. There were no statistically significant between‐group differences in the Mod‐MPI, isovolumetric contraction time (ICT), and ejection time (ET) (P > .05). There was also no statistically significant correlation between the Mod‐MPI in the fetuses with AED and the control group for Mod‐MPI (P > .05). Conclusion The utility of the Mod‐MPI in FGR remains unclear. Future studies with larger populations are needed to determine the utility of the Mod‐MPI as a predictor of cardiac compromise in FGR.

show abstract

Fetal myocardial performance index in pregnancies with idiopathic mildly increased amniotic fluid volume

Attar

Hafezi

2020

J of Clinical Ultrasound

View full text Add to dashboard Cite

PurposeTo evaluate modified myocardial performance index (MPI), or Tei index, in fetuses of pregnancies with idiopathic mildly increased amniotic fluid index (AFI).MethodsWe studied 25 cases (24‐40 weeks) with idiopathic mildly increased AFI, and 25 gestational age‐ and fetal gender‐matched healthy controls. Fetal echocardiographic variables and Doppler‐derived indices were recorded, including left and right MPI, left isovolumetric contraction time (IVCT), left ejection time (ET), left isovolumetric relaxation time (IVRT), aortic and pulmonary arterial peak systolic velocity (PSV), left and right E/A ratios, middle cerebral artery (MCA) pulsatility index (PI), and umbilical artery (UA) PI.ResultsThe mean left MPI (0.52 vs 0.41, P < .0001) and right MPI (0.50 vs 0.42, P < .001) were higher, and mean IVCT (37.7 vs 25.9, P < .0001) was longer in cases than in controls. However, there were no significant differences between the two groups in IVRT (45.2 vs 43.2, P = .381), ET (160.2 vs 170.0, P = .079), aortic PSV (P = .073), left E/A (P = .080), pulmonary artery PSV (P = .061), right E/A (P = .054), MCA PI (P = .259), UA PI (P = .685), and cerebroplacental ratio (P = .645).ConclusionPregnancies with idiopathic mildly increased AFI were associated with a significant increase in the fetal MPI of both left and right ventricles.

show abstract

Assessment of fetal myocardial performance index in women with pregestational and gestational diabetes mellitus

Abstract: We conclude that fetuses of diabetic mothers have significant left ventricular systolic and diastolic dysfunction. MPI may be used in the prediction of adverse perinatal outcome in diabetic pregnancies.

Cited by 48 publications

References 33 publications

Exposure of the developing heart to diabetic environment and early cardiac assessment: A review

Exposure of the developing heart to diabetic environment and early cardiac assessment: A review

Utility of the modified myocardial performance index in growth‐restricted fetuses

Fetal myocardial performance index in pregnancies with idiopathic mildly increased amniotic fluid volume

Contact Info

Product

Resources

About