Role of myocardial performance index (MPI) and cerebro-placental ratio (CPR) in predicting adverse perinatal outcome.

Abstract

This study aimed to evaluate the association of the Myocardial Performance Index (MPI) and Cerebro-Placental Ratio (CPR) in predicting adverse perinatal outcomes in fetuses who are appropriately-grown (AGA), small-for-gestational-age (SGA) and growth restricted (FGR). Singleton pregnancies were recruited after 24weeks. The patients were recruited after having been classified as AGA (AC/EFW>10thcentile), SGA (AC/EFW-3rd-10thcentile without doppler abnormalities), and FGR (AC/EFW<3rdcentile or 3rd-10thcentile with doppler abnormalities). A total of 103 cases comprising 48 AGA, 11 SGA, and 44 FGRfetuses were recruited. The Pulsatility Index of the Umbilical artery, Middle cerebral artery, Ductus Venosus, and Aortic Isthmus was obtained. MPI and CPR were calculated too. The primary outcome was to evaluate the predictive value of MPI and CPR for the composite adverse perinatal outcome. The mean gestational age of recruitment was 30weeks. The OR for Composite Adverse Perinatal Outcome in FGR groupfor MPI>.47 and CPR<1.67was 3.48 (95% CI: 1.00-12.24, p-value<.05)with sensitivity and specificity of 65% each and 11.08 (95% CI: 2.62-46.83, p-value=.001)with the sensitivity of 82% and specificity of 70%, respectively. When combined together, MPI and CPR yielded an OR of 58.5 (95% CI: 4.58-746.57, p-value=.002) with a sensitivity of 56.5% and specificity of 95% in the FGR group. MPI in conjunction with CPR can be used together to predict adverse perinatal outcomes in FGR.