Use of the myocardial performance index as a prognostic indicator of adverse fetal outcome in poorly controlled gestational diabetic pregnancies

Abstract

There is significant impairment of cardiac function in fetuses of poorly controlled gestational diabetics. Mod-MPI and E/A ratio have the potential to improve fetal surveillance in diabetic pregnancies.

Can the Myocardial Performance Index Be Used as a New Predictive Factor for a Poor Prognosis in Fetuses With Idiopathic Polyhydramnios?

“…Another study observed a significant correlation between an increased myocardial performance index and perinatal mortality, which persisted after adjustment for gestational age 23 . In fetuses of poorly controlled gestational diabetes mellitus, a myocardial performance index of greater than 0.52 had sensitivity of 100% and specificity of 92% for prediction of one of several outcomes, including stillbirth, tachypnea, neonatal intensive care unit admission, and neonatal death 24 . In addition, myocardial performance index elevation was significantly associated with worse perinatal outcomes compared with a normal value, whether the umbilical artery Doppler findings were normal or abnormal 25 .…”

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

“…To our knowledge, the first study evaluating the potential success of fetal MPI for the prediction of adverse fetal outcomes in gestational diabetic pregnancies was recently performed by Bhorat et al . A left ventricular MPI value > 0.52 was reported with a sensitivity of 100% and a specificity of 92% for the prediction of adverse perinatal outcomes, including one stillbirth and one neonatal death.…”

“…The E (early ventricular filling) and A (active atrial filling) wave peak velocities were denoted as positive flow, and the E/A ratio was calculated as an index of ventricular diastolic function …”

Fetal left modified myocardial performance index measured by the Auto Mod-MPI system: development of reference values and application to recipients of twin-to-twin transfusion syndrome

“…Because of such discrepancies, although many studies have assessed cardiac function in various complicated conditions, their value in clinical practice is limited. Recent studies suggested cut‐off Mod‐MPI values for predicting adverse outcomes in gestational diabetes and IUGR . However, these studies did not describe cursor placement (i.e.…”