Use of the Myocardial Performance Index in Decreased Fetal Movement Assessment: A Case-Control Study

Abstract

Objectives: To determine whether there are any fetal cardiac function changes, as measured by the myocardial performance index (MPI), in pregnancies complicated by decreased fetal movement (DFM). Methods: We performed a prospective cross-sectional case-control study of 50 DFM and 50 uncomplicated third-trimester pregnancies matched within 2 gestational weeks. Routine ultrasound growth and well-being parameters as well as MPI were measured. Average MPI measurements and its component values were compared between the DFM and the control group, as were demographics, other ultrasound data, and perinatal outcomes. Results: Average left MPI (LMPI) and right MPI (RMPI) was similar between groups (LMPI: 0.54 ± 0.08 [DFM], 0.53 ± 0.08 [controls], p = 0.76; RMPI: 0.60 ± 0.12 (DFM), 0.59 ± 0.11 [controls], p = 0.79). However, subgroup analysis of DFM fetuses with (n = 20) or without (n = 30) any adverse perinatal outcome demonstrated modestly higher average RMPI and LMPI in the adverse perinatal outcome group (RMPI: 0.64 ± 0.08 vs. 0.57 ± 0.13, p = 0.02; LMPI: 0.56 ± 0.07 vs. 0.52 ± 0.07, p = 0.052). Conclusion: The MPI did not demonstrate clinically usable differences between the overall DFM population and controls. However, higher LMPI and RMPI values in the exploratory subgroup of DFM fetuses with adverse perinatal outcomes may warrant further exploration of the MPI in DFM.

Pregnancy, birth and neonatal outcomes associated with reduced fetal movements: A systematic review and meta-analysis of non-randomised studies

“…On further review of these 51 studies, 12 studies did not report on specified outcomes following RFM and were subsequently excluded. This resulted in a final inclusion of 39 nonrandomised studies ( Akselsson, Lindgren, Georgsson, Pettersson, & Rådestad, 2019 ;Aviram et al, 2016 ;Binder, Monaghan, Thilaganathan, Morales-Roselló, & Khalil, 2018 ;Bradford et al, 2019 ;Christou et al, 2019 ;Daly, Brennan, Foley, & O'Herlihy, 2011 ;Eng, Karki, & Trivedi, 2016 ;Eshraghi, Jamal, Eshraghi, Kashanian, & Sheikhansari, 2020 ;Harrington et al, 1998 ;Heazell et al, 2018 ;Heazell et al, 2017 ;Ho et al, 2018 ;Holm Tveit, Saastad, Stray-Pedersen, Bordahl, & Froen, 2009 ;Inukollu, Sulthana, Solipuram, Kunamneni, & Kothagadi, 2021 ;Levy, Kovo, Barda, et al, 2020 ;Levy, Kovo, Izaik, et al, 2020 ;Linde, Pettersson, & Radestad, 2017 ;McCarthy et al, 2016 ;O'Sullivan, Stephen, Martindale, & Heazell, 2009 ;Olagbuji, Ezeanochie, Kubeyinje, Dunsin, & Ande, 2011 ;Pagani, D'Antonio, Khalil, Akolekar, et al, 2014 ;Sadovsky, Yaffe, & Polishuk, 1974 ;Y. H. Sage & R. Fretts, 2012b ;Saglam et al, 2022 ;Sheikh, Hantoushzadeh, & Shariat, 2014 ;Sinha, Sharma, Nallaswamy, Jayagopal, & Bhatti, 2007 ;Skornick-Rapaport et al, 2004 ;Stacey et al, 2011 ;Sterpu et al, 2020 ;Turner et al, 2021 ;Valencia-Rincon et al, 2017 ;Valentin & Marsal, 1987 ;Warrander et al, 2012 ;…”

Prenatal Echo-Sonographic Parameters in Fetuses Wrapped with the Umbilical Cord in the Third Trimester of Pregnancy

“…Ho et al [12] analyzed fetal RV Tei in a group of 50 fetuses in the third trimester of pregnancy when mothers reported a reduction in fetal movements in relation to the control group (Tei RV 0.60 ± 0.12 vs. 0.59 ± 0.11) with no significant differences [12].…”

Poor Correlation between Fetal Tissue Doppler Imaging and Pulsed Wave Myocardial Performance Indices

“…Myocardial Performance Indices (MPIs) are calculated using pulsed wave Doppler (PWD) ultrasound recordings of blood flow through the atrioventricular and semilunar valves [1,2]. PWD-MPI values have been shown to correlate with a range of fetal pathologies including intra-uterine growth restriction (IUGR) [3][4][5], twintwin transfusion syndrome [6][7][8], maternal diabetes [9][10][11], pre-eclampsia [12], cholestasis [13], and decreased fetal movements [14].…”