Abstract

AimTo 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.MethodsThis 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.ResultsCompared 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.ConclusionFetal 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.

Highlights

  • Fetal growth restriction (FGR) has been a challenging issue in clinical practice

  • The aim of this study was to investigate the changes of Myocardial performance index (MPI) in early‐ and late‐onset FGR cases with different Doppler manifestations and its association with adverse perinatal outcome, to further confirm the clinical value of MPI in detecting and monitoring FGR

  • Mod‐MPI (OR = 3.307, 95% CI 1.425–7.674, P = 0.005) and umbilical artery (UA) pulsatility index (PI) (OR = 1.542, 95% CI 1.181–2.013, P = 0.001) were associated with adverse outcome in early‐onset FGR

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Summary

| INTRODUCTION

Fetal growth restriction (FGR) has been a challenging issue in clinical practice. It is significantly related to adverse perinatal outcome. The intrauterine safety of fetuses has been evaluated extensively by Doppler parameters of umbilical artery (UA), middle cerebral artery (MCA), and ductus venous (DV).[3-5]. The changes of these vessels’ Doppler flow reflect the worsening of the cardiovascular condition of fetuses. Myocardial performance index (MPI) is one of the indicators of fetal cardiovascular situations It is a noninvasive Doppler‐derived indicator that evaluates global myocardial function.[6]. The aim of this study was to investigate the changes of MPI in early‐ and late‐onset FGR cases with different Doppler manifestations and its association with adverse perinatal outcome, to further confirm the clinical value of MPI in detecting and monitoring FGR MPI has been proved to be a reliable parameter, not being affected by fetal cardiac ventricular size, fetal heart rate, and geometry.[7,8] Some studies have demonstrated that FGR cases were associated with prenatal adverse cardiac remodeling.[9,10] The aim of this study was to investigate the changes of MPI in early‐ and late‐onset FGR cases with different Doppler manifestations and its association with adverse perinatal outcome, to further confirm the clinical value of MPI in detecting and monitoring FGR

| METHODS
Findings
| DISCUSSION
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