Fetal cardiac function measured by myocardial performance index of small‐for‐gestational age fetuses

Abstract

Aim: The aim of this study was to demonstrate the changes of right and left myocardial performance indices (MPI) in small-for-gestational age (SGA) fetuses during 28-40 weeks of gestation. Material and Methods: Singleton pregnant women during 28-40 weeks of gestation were enrolled. Estimated fetal weight was used to classify the subjects into appropriate-for-gestational age (AGA) and SGA groups. The Doppler indices of umbilical and middle cerebral arteries, including amniotic fluid index, were used to distinguish constitutional SGA (both normal Doppler indices and amniotic fluid index) from intrauterine growth restriction (IUGR) fetuses (abnormal Doppler indices and/or oligohydramnios). MPI was obtained and compared between the groups. Inter-and intra-observer variations were also assessed. Results: Fifty women had AGA fetuses whereas another 50 cases had SGA fetuses (41 constitutional SGA and nine IUGR). Right MPI in AGA fetuses was constant whereas left MPI was slightly increased. The MPI of SGA fetuses were significantly greater than those of AGA fetuses starting from 30 weeks gestation until delivery (P < 0.01 and <0.05 in right and left side, respectively). Subgroup analysis demonstrated right and left MPI of IUGR fetuses increased with advancing gestation and were significantly greater than those of constitutional SGA and AGA fetuses, which appeared to be similar. The reproducibility of the test was high. Conclusions: In SGA fetuses, the MPI of right and left ventricles was significantly increased with advancing gestation compared to AGA cases.

Turkish reference ranges for the left fetal modified myocardial performance index

“…Previous studies have demonstrated that pathological conditions that could influence cardiac functions also alter the Mod-MPI values. [5][6][7][8][9][10][11][12][13][14][15] In the present study, all of the UA S/D values were in the normal ranges based on GA. Therefore, we could not interpret this result objectively.…”

“…Fetal growth restriction, twin-twin transfusion syndrome, maternal diabetes, preeclampsia, fetal hydrops, fetal anemia, and cholestasis are examples of these conditions. [5][6][7][8][9][10][11][12][13][14][15] MPI values may be a guide for fetal interference and timing of the delivery in cases that affect cardiac function. However, it is important to ensure that the measurement of MPI is consistent and accurate.…”

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

“…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.…”

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

“…The MPI is still being investigated as a potential determinant of cardiac performance for new indications in children and adults, because of its simplicity, non‐invasiveness, straightforwardness and reproducibility . In addition, there is also reported data on the success of MPI in the prenatal period for the identification of fetal ventricular dysfunction . Moreover, the E wave/A wave peak velocity (E/A) ratio at the mitral valve was additionally defined as another tool for ventricular function analysis, but only for the diastolic component.…”