Evaluation of the Fetal Myocardial Performance Index in Abnormal Cardiotocography Cases in 3rd Trimester of Pregnancy and Fetal Outcome

Abstract

Background: Cardiotocography is broadly used, particularly in pregnancies with an elevated probability of risks, to assess fetal well-being. The study's objective was to evaluate the accuracy of the myocardial performance index (MPI) in predicting fetal distress in pregnant women with unsatisfactory cardiotocography. Methods: This prospectivestudy included 145 women in late pregnancy divided into two groups: Cases (n=72) including women with abnormal cardiotocography and Controls (n=73) including women with normal cardiotocography. Results: The MPI significantly increased in cases compared to control groups (0.46 vs. 0.38, p<0.001). In heatmap correlation, the MPI remained a significant negative correlation with Apgar score At 1 and 5 min., acceleration, and variability, whilethe positive correlation with ET, FHR, deceleration, and mode of delivery. A cut-off MPI of ≥0.51 conferred a specificity of 71.23 %, sensitivity of 65.28 %. Conclusion: MPI measurement during the third trimester is a promising surrogate marker for abnormal cardiotocography (CTG) and fetal distress. Women with abnormal cardiotocography (CTG) had significantly higher MPI and worse fetal outcomes.