RETRACTED: Normal reference ranges for fetal cardiac function: Assessed by modified Doppler myocardial performance index (Mod MPI) in the Egyptian population

Ali, Sief El-Eslam A.; Okasha, Ahmed; Elsirgany, Sherif; Abdel-Rasheed, Mazen; Khalil, Ahmed; Elanwary, Sherif; El-Sheikhah, Ahmad

doi:10.1016/j.ejogrb.2020.05.011

Cited by 7 publications

(10 citation statements)

References 37 publications

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“…Population-based normal reference ranges may be helpful. Ali et al [26] have published a normal reference range for Egyptian population, yet it needs to be validated; their 95 th percentile values are much higher than the previously published reference values, and are even much higher than the reported cutoff values in pathologic conditions like IUGR and maternal diabetes mellitus.…”

Section: Discussionmentioning

confidence: 88%

The Prediction of Adverse Perinatal Outcomes in Intrauterine Growth Restriction using the Doppler Indices of Myocardial Performance and Aortic Isthmus

Bellehy

Omar

Eid

et al. 2020

International Journal of Medical Arts

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Background: Intrauterine growth restriction [IUGR] represented a challenging health problem, faced during daily clinical practice. Early diagnosis is of crucial importance. Aim of the work: To determine the value of the aortic isthmic flow index and the left mod-myocardial performance index [MPI] in the prediction of adverse perinatal outcomes in fetuses affected by IUGR. Patients and Methods: Forty Singleton fetuses with IUGR between 28 and 34 weeks were recruited. The left mod-MPI and the isthmic flow index [IFI] were calculated. Ultrasound indices had been correlated with perinatal outcome. Results: There was a statistically significant association between abnormal aortic isthmus diastolic flow and low 1-minute Apgar score and neonatal intensive care unit [NICU] admission. There was a statistically significant association between the left mod-MPI and the meconium stained amniotic fluid [AF], the need for Neonatal resuscitation, NICU admission, neonatal sepsis, and neonatal death. When considering cutoff value for prediction of adverse fetal outcome by Left MPI, a cutoff of 0.53 confers 85.2% sensitivity, 80% specificity, PPV 92%, NPV 66.7%, and accuracy of 83.8%. In addition, 85% of fetuses had normal Aortic isthmus [AoI] waveform [IFI type I] and 15% had abnormal AoI waveform, and there was a statistically significant association between abnormal AoI diastolic flow and each of [IFI of II, III, V], [low 1-minute Apgar score] and [NICU admission]. Conclusion: AoI IFI and left mod-MPI could be considered valuable for the assessment of chronic placental insufficiency, and play a role in prediction of adverse perinatal outcome associated with IUGR.

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Section: Discussionmentioning

confidence: 88%

The Prediction of Adverse Perinatal Outcomes in Intrauterine Growth Restriction using the Doppler Indices of Myocardial Performance and Aortic Isthmus

Bellehy

Omar

Eid

et al. 2020

International Journal of Medical Arts

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“…Two studies included women with diabetes, but the incidence of type 1 or 2 diabetes and GDM was not mentioned among women with obesity or controls [ 33 , 41 ]. Two other articles did not mention type 1 or 2 diabetes and GDM [ 31 , 40 ]. In the remaining studies, the prevalence of GDM ranged from 3.2% to 44.4% among women with obesity.…”

Section: Resultsmentioning

confidence: 99%

“…Ten articles included data measured by echocardiography [28][29][30][31][32][33][34][35][36][37][38], and two articles reported on data measured by MRI [39,40].…”

Section: Plos Onementioning

confidence: 99%

“…Table 1 shows the characteristics of the included studies. Six articles reported on outcomes in fetuses (n = 1483) [28][29][30][31][32][33], three articles on outcomes in neonates (n = 187) [34,35,39], three on outcomes in infants (children <1 year of age) (n = 234) [34][35][36] and three articles reported on outcomes in children older than 1 year of age (n = 6966) [38,40,41]. No articles reported on cardiac structure or function in adolescents or adults born to women with obesity.…”

Section: Plos Onementioning

confidence: 99%

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Maternal obesity in pregnancy and children’s cardiac function and structure: A systematic review and meta-analysis of evidence from human studies

et al. 2022

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The prevalence of obesity is increasing worldwide. Experimental animal studies demonstrate that maternal obesity during pregnancy directly affects cardiac structure and function in their offspring, which could contribute to their increased cardiovascular disease (CVD) risk. Currently, a systematic overview of the available evidence regarding maternal obesity and alterations in cardiac structure and function in human offspring is lacking. We systematically searched the electronic databases Embase, MEDLINE and NARCIS from inception to June 29, 2022 including human studies comparing cardiac structure and function from fetal life onwards in offspring of women with and without obesity. The review protocol was registered with PROSPERO International Prospective Register of Systematic Reviews (identifier: CRD42019125071). Risk of bias was assessed using a modified Newcastle-Ottawa scale. Results were expressed using standardized mean differences (SMD). The search yielded 1589 unique publications, of which thirteen articles were included. Compared to offspring of women without obesity, fetuses of women with obesity had lower left ventricular strain, indicative of reduced systolic function, that persisted in infancy (SMD -2.4, 95% confidence interval (CI) -4.4 standard deviation (SD) to -0.4 SD during fetal life and SMD -1.0, 95% CI -1.6 SD to -0.3 SD in infancy). Furthermore, infants born to women with obesity had a thicker interventricular septum (SMD 0.6 SD, 95% CI 0.0 to 1.2 SD) than children born to women without obesity. In conclusion, cardiac structure and function differs between fetuses and children of women with and without obesity. Some of these differences were present in fetal life, persisted in childhood and are consistent with increased CVD risk. Long-term follow-up research is warranted, as studies in offspring of older age are lacking.

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“…Antenatal MPI assessment has been demonstrated to successfully identify fetal ventricular dysfunction [ 15 , 16 ]. The normal reference range for MPI has been reported to be 0.408 ± 0.08 SD and this does not seem to be affected by maternal age, body mass index (BMI) or parity [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Fetal echocardiographic parameters in pregnancies complicated by diabetes: a case control study

Darwish

Abdel-Raouf

Kamel

et al. 2022

BMC Pregnancy Childbirth

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Background At present, the prevalence of pregestational diabetes is 2.2% with an overall prevalence of hyperglycaemia in pregnancy of about 16.2%. Fetuses of diabetic mothers are at risk of functional cardiac abnormalities without structural cardiac anomalies especially in the third trimester. The main aim of this study was to assess the association of diabetes with different fetal echocardiographic parameters. Methods A case control study comprising a total of 120 pregnant women (60 cases and 60 controls). The cases group included fetuses of mothers known to have pre-gestational type 2 diabetes (DM group) while the control group included fetuses of euglycaemic healthy pregnant women. They were examined twice at 23–24 weeks' gestation (visit 1) and followed up at 27–28 weeks’ gestation (visit 2). The Modified Myocardial Performance Index (Mod MPI) was obtained in all fetuses. Also, M-mode echocardiography was used to measure the interventricular septum thickness at diastole in a transverse four chamber view. Results There was a significant increase in Iso-volumetric contraction time (ICT) (45.4 ms ± 8.9), Iso-volumetric relaxation time (IRT) (54.7 ms ± 11.22), Interventricular septal thickness (IVST) (4.08 mm ± 0.8), aortic acceleration time (AAT) (54.16 ms ± 12.77) and MPI (0.64 ± 0.09) in the diabetic group compared to the normal control group ICT (38.5 ms ± 9.59), IRT (46.13 ms ± 10.29), IVST (3.17 mm ± 0.6), AAT (49.73 ms ± 10.68) and MPI (0.5 ± 0.1) (all P values were < 0.001). When comparing parameters assessed at both visits among diabetic patients, there was a significant increase in IVST in the second visit (4.74 ± 0.78 mm) compared to the first visit (4.08 ± 0.8 mm) (P value < 0.05). The incidence of hypertrophic cardiomyopathy (HCM) was significantly higher in diabetic patients than in the control group. This is was observed in both first and second visit (33.4% and 56.7%) (P value < 0.001). Conclusions Fetuses of diabetic pregnant females show a significant increase in MPI, decrease in E\A ratio and HCM. These alterations in cardiac functions and structure were found to be continuous throughout the period of time between the two visits.

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RETRACTED: Normal reference ranges for fetal cardiac function: Assessed by modified Doppler myocardial performance index (Mod MPI) in the Egyptian population

Cited by 7 publications

References 37 publications

The Prediction of Adverse Perinatal Outcomes in Intrauterine Growth Restriction using the Doppler Indices of Myocardial Performance and Aortic Isthmus

The Prediction of Adverse Perinatal Outcomes in Intrauterine Growth Restriction using the Doppler Indices of Myocardial Performance and Aortic Isthmus

Maternal obesity in pregnancy and children’s cardiac function and structure: A systematic review and meta-analysis of evidence from human studies

Fetal echocardiographic parameters in pregnancies complicated by diabetes: a case control study

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