Fetal and Neonatal Modified Myocardial Performance Indices in Preeclamptic versus Normotensive Pregnancies: A Prospective Cohort Study

Abstract

Objective To compare fetal and neonatal cardiac functions in terms of global, systolic, and diastolic function between the preeclampsia and normotensive blood pressure of pregnancies. Methods A prospective cohort study was conducted at a university hospital in Northeast Thailand. Twenty-nine pregnancies diagnosed as preeclampsia with or without severe features were compared with 29 normotensive pregnancies. Global cardiac, systolic, and diastolic function were assessed at prenatal and postnatal periods, by a professionally trained obstetrician and pediatric cardiologist, respectively. Results The fetal left modified myocardium performance index (Mod-MPI) in preeclampsia and normotensive blood pressure were 0.60±0.08 and 0.59±0.08 ( p -value=0.341), respectively, while fetal right Mod-MPI were 0.57±0.16 and 0.54±0.21 ( p -value=0.861), respectively. There were no statistically significant differences in terms of fetal isovolumic contraction time (ICT), isovolumic relaxation time (IRT), ejection time (ET), aortic peak systolic velocity (Ao PSV), pulmonary artery peak systolic velocity (PA PSV), mitral valve (MV) E:A ratio, or tricuspid valve (TV) E:A ratios between the two groups. Neonatal mitral valve E peak systolic velocity (MV-E PV) in preeclamptic and normotensive blood pressure groups were significantly different at 51.1±8.02 cm/s and 43.56±5.21cm/s ( p -value=0.036), respectively, whereas neonatal left Mod-MPI, mitral valve A peak systolic velocity (MV-A PV), MV E:A ratio, and Ao PSV were not significantly different ( p -value=0.436, 0.119, 0.379, and 0.709), respectively. Conclusion Neonatal MV-E PV of the preeclampsia group was significantly higher than the normotensive blood pressure group, while there were no statistically significant differences in terms of global cardiac and diastolic functions during the fetal period between two groups.

Effect of magnesium sulfate seizure prophylaxis on fetal myocardial performance index in severe preeclampsia and eclampsia

“…There are studies that have investigated preeclampsia and fetal cardiac function by MPI but they did not find any significant difference [16,17]. However, there is no previous study that aimed to evaluate the effect of magnesium sulfate prophylaxis used for prevention of seizures in preeclamptic/eclamptic pregnant women on fetal cardiac function.…”

A new Doppler index, cerebro‐placental‐uterine ratio, and fetal cardiac parameters in early onset preeclampsia

“…10 Pathologic conditions such as FGR, diabetes mellitus, preeclampsia, twin-to-twin transfusion syndrome (TTTS), and fetal anemia have been shown to alter MPI rates. 11,12 Numerous studies suggest that this condition may offer insights into the clinical management of the disease and its impact on cardiac function. [10][11][12] The splanchnic mesoderm gives rise to epicardial adipose tissue (EAT), which is located between the myocardium and the visceral pericardium.…”

“…11,12 Numerous studies suggest that this condition may offer insights into the clinical management of the disease and its impact on cardiac function. [10][11][12] The splanchnic mesoderm gives rise to epicardial adipose tissue (EAT), which is located between the myocardium and the visceral pericardium. The effects of the EAT include endocrine, immunologic, inflammatory, and energy storage effects.…”

“…Hernandez‐Andrade et al used a modified approach, in which the opening and closing Doppler clicks of the aortic and mitral valves serve as markers for identifying the different time segments to avoid changes within and between observations 10 . Pathologic conditions such as FGR, diabetes mellitus, preeclampsia, twin‐to‐twin transfusion syndrome (TTTS), and fetal anemia have been shown to alter MPI rates 11,12 . Numerous studies suggest that this condition may offer insights into the clinical management of the disease and its impact on cardiac function 10–12 .…”

Impact of hypertensive disorders of pregnancy on offspring cardiovascular function. Study from fetal life to early childhood

“…However, inconsistencies exist with regard to the influence of HDP on cardiac structural and functional changes in postnatal life. For instance, some studies have reported no difference in cardiac function in the neonatal period 9 , whereas others reported a reduction in diastolic functional indices in adolescence 7,10 . Whether these discrepancies reflect differences in the offspring's risk-factor profile or a direct programming effect of HDP on the offspring's cardiovascular system remains to be established 11 .…”