Fetal myocardial performance index in assessment and management of small‐for‐gestational‐age fetus: a cohort and nested case–control study

Henry, Amanda; Alphonse, Jennifer; Tynan, Dominique; Welsh, A.W.

doi:10.1002/uog.17476

Cited by 18 publications

(25 citation statements)

References 53 publications

(91 reference statements)

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“…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.…”

Section: Discussionsupporting

confidence: 56%

“…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.…”

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confidence: 99%

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Turkish reference ranges for the left fetal modified myocardial performance index

Yakut¹,

Öcal²,

Öztürk³

et al. 2021

Turk J Pediatr

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Background. This study aimed to assess fetal cardiac left ventricular function in healthy pregnant women by calculating the modified myocardial performance index (Mod-MPI) and to construct reference ranges for the Turkish population.Methods. One-hundred-two randomly selected healthy singleton pregnant women ranging between 25 and 39 gestational weeks were included in the study. Left fetal Mod-MPI was measured for each pregnant woman. Women with chronic systemic diseases or fetuses with chromosomal or structural abnormalities were excluded from the study. Mitral valve (MV) and aortic valve (AoV) clicks were used as landmarks to define the following time periods that were used to calculate the Mod-MPI: isovolumetric contraction time (ICT), isovolumetric relaxation time (IRT), and ejection time (ET).Results. The mean Mod-MPI was 0.42±0.10. The mean IRT, ICT, and ET were 43.5±10.2, 27.27±8.1, and 170.5±16.9, respectively. A significant correlation was found between Mod-MPI and gestational age, umbilical artery systolic/diastolic (UA S/D) ratio and the middle cerebral artery pulsatility index (MCA PI) values (r=0.199, p=0.047, p=0.001, p=0.001, respectively) Conclusions. The current study's results will be a reference for future studies, especially studies investigating pathological conditions that impact fetal cardiac function.

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Section: Discussionsupporting

confidence: 56%

mentioning

confidence: 99%

Turkish reference ranges for the left fetal modified myocardial performance index

Yakut¹,

Öcal²,

Öztürk³

et al. 2021

Turk J Pediatr

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“…There were no significant correlations between the left MPI and adverse perinatal outcomes. Exploratory subgroup comparisons revealed only minor differences in MPI, reaching statistical significance, only in the EFW<3 rd vs 3 rd -10 th centile comparison [23] . Our study in contrast, revealed that 87.5% of fetuses had an abnormal MPI value [more than 95 th centile].…”

Section: Discussionmentioning

confidence: 77%

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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“…Nassr et al showed that MPI was a potentially useful tool which was crucial in classifying FGR pregnancies and predicting neonatal outcome. However, Henry et al monitored 38 early‐onset and 14 late‐onset FGR fetuses and concluded that MPI was not of clinical value in assessment and management of SGA/FGR fetuses. Pacheco et al monitored 24 appropriate growth fetuses, 30 fetuses with EFW between the 3rd and 10th centiles, and 22 fetuses with EFW < 3rd centile and also showed that MPI was not significantly different between fetuses with appropriate GA and those with growth restriction.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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Aim To investigate the changes of modified myocardial performance index (Mod‐MPI) in early‐onset and late‐onset fetal growth restriction (FGR) cases, and its association with adverse perinatal outcome. Methods This was a prospective study on 77 early‐onset and 100 late‐onset FGR cases. Hundred normal fetuses were matched as control groups for early‐onset and late‐onset FGR groups, respectively. Mod‐MPI and vessel Doppler parameters including umbilical artery (UA), ductus venosus (DV), and middle cerebral artery (MCA) were measured. Perinatal outcomes were followed up. Mod‐MPI of FGR cases were compared in normal Doppler, abnormal Doppler, and control groups. The association of Mod‐MPI and perinatal outcome was investigated, and further efficacy of Mod‐MPI predicting adverse outcome was studied. Results Compared with control groups, both abnormal and normal Doppler groups showed increased Mod‐MPI in early‐onset and late‐onset FGR, respectively. Mod‐MPI had no significant difference between abnormal and normal Doppler groups. Mod‐MPI was associated with adverse outcome in early‐onset FGR (OR = 3.307) and late‐onset FGR (OR = 3.412). The sensitivity and specificity of Mod‐MPI predicting adverse outcome were 60% and 80% when cutoff value was 0.47 in early‐onset FGR. And they were 65% and 70% when cutoff value was 0.50 in late‐onset FGR. Conclusion Fetal growth restriction fetuses had increased Mod‐MPI. Mod‐MPI could be used to predict adverse perinatal outcome of FGR fetuses. Mod‐MPI was an effective parameter to supplement vessels’ Doppler parameters in monitoring FGR.

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Fetal myocardial performance index in assessment and management of small‐for‐gestational‐age fetus: a cohort and nested case–control study

Cited by 18 publications

References 53 publications

Turkish reference ranges for the left fetal modified myocardial performance index

Turkish reference ranges for the left fetal modified myocardial performance index

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

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

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