Contribution of the myocardial performance index and aortic isthmus blood flow index to predicting mortality in preterm growth‐restricted fetuses

Hernández‐Andrade, Edgar; Crispi, F.; Benavides‐Serralde, J. A.; Plasencia, W.; Diesel, Horacio Figueroa; Eixarch, Elisenda; Acosta-Rojas, Ruthy; Figueras, F.; Nicolaides, Kypros H.; Gratacós, E.

doi:10.1002/uog.7347

Cited by 82 publications

(103 citation statements)

References 37 publications

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“…Absent or reversed flow during atrial contraction heralds fetal death by about 7 days, approximately 4 days earlier than methods based on biophysical profile score 10,11 . Since, as shown in this study, DV-PI and MPI progress in parallel, it is not surprising that previous studies have demonstrated that while MPI may improve the prediction of fetal death, its added value is modest when combined with DV flow 34 . We and others have previously reported that in IUGR fetuses AoI flow becomes abnormal on average 1 week earlier than does DV flow 16,17 , which may help to explain its reported poor short-term use in the prediction of fetal death 34 .…”

Section: Discussionsupporting

confidence: 56%

“…Since, as shown in this study, DV-PI and MPI progress in parallel, it is not surprising that previous studies have demonstrated that while MPI may improve the prediction of fetal death, its added value is modest when combined with DV flow 34 . We and others have previously reported that in IUGR fetuses AoI flow becomes abnormal on average 1 week earlier than does DV flow 16,17 , which may help to explain its reported poor short-term use in the prediction of fetal death 34 . However, AoI flow has shown a strong association with neurological outcome 15 .…”

Section: Discussionsupporting

confidence: 56%

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Sequence of changes in myocardial performance index in relation to aortic isthmus and ductus venosus Doppler in fetuses with early‐onset intrauterine growth restriction

Cruz‐Martínez

Figueras

Benavides-Serralde

et al. 2011

Ultrasound in Obstet & Gyne

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Section: Discussionsupporting

confidence: 56%

Section: Discussionsupporting

confidence: 56%

Sequence of changes in myocardial performance index in relation to aortic isthmus and ductus venosus Doppler in fetuses with early‐onset intrauterine growth restriction

Cruz‐Martínez

Figueras

Benavides-Serralde

et al. 2011

Ultrasound in Obstet & Gyne

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“…In addition, Figueras et al observed that abnormal alteration in aortic isthmus blood flow occurs 1 week prior than does that in ductus venosus among preterm growth restricted fetuses. Doppler evidence of retrograde flow in the aortic isthmus also found to be strongly correlated with adverse perinatal outcome in IUGR complicated pregnancies as explored in the study observed by Figueras et al [6][7][8][9][10]. The study conducted by Hernandez-Andrade et al at Spain reported 22% of perinatal death among IUGR subjects which showed significant prediction with predetermined myocardial performance index as well as prolonged NICU stay [6].…”

Section: Discussionmentioning

confidence: 91%

Altered Arterial Doppler Flow Pattern and Perinatal Outcome in Intrauterine Growth Restriction

Shetty

Nayak

Kumar

et al. 2017

Asian J Pharm Clin Res

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Objectives: Intrauterine growth restriction (IUGR) is one of the common conditions that interfere with the growth of the fetus accounting for 10-15% of pregnant woman. Literature explores a wide range of incidence of perinatal complication including mortality among IUGR pregnancies. Limited data available on these complications confined to coastal Karnataka and its association with abnormal arterial Doppler flow pattern. To study the perinatal complications associated with IUGR pregnancies and its prevalence in comparison to healthy controls of comparable gestational age. Methods:This cohort study screened 53 IUGR fetuses by an antenatal scan at gestational age of 27 weeks or more. The diagnosis of IUGR was made according to established criteria from SOGC clinical practice guidelines August 2013. The data also included 48 appropriate for gestational age fetuses with healthy mothers with the comparable gestational week. Experienced cardiac sonographer and gynecologist performed fetal echocardiography (ECHO) using Vivid 7, GE health-care system ECHO machine with the convex transducer of frequency 1.7-2.4 MHz. The study was conducted at south Indian tertiary care center.Results: This study included 53 IUGR cases and 48 non-IUGR controls. The mean age was 27±4.37 and 26.88±3.14 years in IUGR and non-IUGR groups, respectively. Fetal Doppler study variables showed a significant decrease in peak aortic velocity and velocity time integral which was not evident on other valves, though mitral antegrade flow during atrial contraction was found to be lower among IUGR group. In two-dimensional chamber quantification of IUGR group revealed significant increase in pulmonary artery dimension, right ventricular (RV) dimension and RV thickness than the control group (p<0.05). The anthropometric parameters such as weight and length; abdomen circumference was significantly lower in IUGR group, whereas head circumference found to be more in IUGR group (p<0.001). The gestational weeks at delivery was significantly different among two groups with IUGR group depicting the early delivery group. p<0.001(35.58±2.92 and 38.5±0.96 in IUGR and non-IUGR groups, respectively). IUGR group also had prolonged neonatal intensive care unit stay when compared to controls (p<0.001).Conclusions: IUGR carries profound course in altered Doppler indices and cardiac function which explore its prediction on mortality and adverse perinatal outcome. This study showed significant perinatal mortality accounting for 5.6% among IUGR cases when compared to normal. Although tissue Doppler indices show normal variants, IUGR possesses significant adverse perinatal outcome, however with lesser incidence compared to severe form of IUGR subsets who show altered tissue annular velocities.

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“…The myocardial performance index (MPI) is a novel method in fetal medicine that assesses both systolic and diastolic functions by including the measurement of isovolumetric and ejection times and would be useful in assessing the progressive hemodynamic deterioration. It has been recently reported to be independently associated with perinatal mortality, mainly in very pre-term IUGR fetuses, 101 although its role as a surveillance tool needs to be further elucidated.…”

Section: Other Cardiac Doppler Parametersmentioning

confidence: 99%

Ultrasound and Doppler Management of Intrauterine Growth Restriction

Carrera¹,

Figueras²,

Meler³

2010

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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Contribution of the myocardial performance index and aortic isthmus blood flow index to predicting mortality in preterm growth‐restricted fetuses

Abstract: Objectives To evaluate the predictive value for perinatal death of the myocardial performance index (MPI) and aortic isthmus flow index (IFI), as isolated parameters and in a combined model including currently used Doppler indices, in preterm growth restricted (IUGR) fetuses. Methods

Cited by 82 publications

References 37 publications

Sequence of changes in myocardial performance index in relation to aortic isthmus and ductus venosus Doppler in fetuses with early‐onset intrauterine growth restriction

Sequence of changes in myocardial performance index in relation to aortic isthmus and ductus venosus Doppler in fetuses with early‐onset intrauterine growth restriction

Altered Arterial Doppler Flow Pattern and Perinatal Outcome in Intrauterine Growth Restriction

Ultrasound and Doppler Management of Intrauterine Growth Restriction

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