Assessment of fetal modified myocardial performance index in early‐onset and late‐onset fetal growth restriction

Zhang, Lina; Han, Jianing; Zhang, Na; Li, Zhen; Wang, Jingjing; Yang, Xuan; Kagan, Karl Oliver; Sun, Li-Ying

doi:10.1111/echo.14364

Cited by 24 publications

(22 citation statements)

References 27 publications

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“…Zhang et al [24] proposed that a cut-off value of the left MPI in fetus with early-onset IUGR of 0.47 conferred a sensitivity of 60%, specificity of 80% for the adverse perinatal outcome. They did not report a cut-off value for prediction perinatal death, which is different than the current work.…”

Section: Discussionmentioning

confidence: 99%

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: 99%

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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“…Moreover, they showed that increased MPI was associated with adverse pregnancy outcomes. 11 Sharma et al measured MPI in 36 FGR and 36 AGA cases. They found significantly higher MPI and IRT in the FGR cohort.…”

Section: Discussionmentioning

confidence: 99%

Fetal cardiac alterations in the late‐onset growth‐restricted fetuses: A prospective case–control study

Türkyilmaz

Turkyilmaz²,

Uygur

2021

J of Obstet and Gynaecol

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Aim: Fetal growth restriction (FGR) has significant consequences on cardiac functions. This study aims to evaluate cardiac functional parameters in late-onset (FGR) fetuses and compare those appropriate for gestational age (AGA) fetuses. Material and Methods: Fifty-six singleton pregnancies were involved in this prospective case-control study. Delphi consensus was used to define late-onset FGR. We compared the E/A ratio, left myocardial performance index (MPI) and tricuspid annular plane systolic excursion (TAPSE) in late-onset FGR cases and gestational age-matched AGA fetuses. Results: Twenty-eight late-onset FGR and 28 AGA fetuses were enrolled. The mean gestational age in the late-onset FGR group was 34.1 AE 2.3 weeks and 34.4 AE 2.1 in controls. The E/A ratio was 0.88 AE 0.09 in AGA fetuses, 0.79 AE 0.11 in the late-onset FGR group, and significantly lower in late-onset FGR fetuses (p: 0.012). Left MPI was 0.51 AE 0.09 in AGA and 0.62 AE 0.11 in the late-onset FGR group. Left MPI was markedly higher in late-onset FGR fetuses (p: 0.024). TAPSE was 7.4 AE 2.9 mm in controls and 5.2 AE 1.8 in the late-onset FGR group, and it was significantly shorter in the late-onset FGR fetuses (p: 0.016). Conclusion: Late-onset FGR is associated with cardiac remodeling and dysfunction. Fetal echocardiography may be beneficial to detect those subtle cardiac changes.

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“…Moreover, it is not possible or advisable to use continuous CTG in limited-resource environments 9 . Functional cardiac assessment using echocardiography is increasingly valued because it detects subtle myocardial dysfunction during growth and can guide treatment and improve neonatal results 10 .…”

Section: Discussionmentioning

confidence: 99%

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

Sakna,

Nasr El din,

Mehanna

et al. 2021

Indian Journal of Forensic Medicine & Toxicology

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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.

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Assessment of fetal modified myocardial performance index in early‐onset and late‐onset fetal growth restriction

Cited by 24 publications

References 27 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

Fetal cardiac alterations in the late‐onset growth‐restricted fetuses: A prospective case–control study

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

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