Modified myocardial performance index for evaluation of fetal cardiac function in pre-eclampsia

Area of Science:

• Cardiology
• Maternal-Fetal Medicine
• Pediatric Cardiology

Background:

• Pre-eclampsia is a serious pregnancy complication.
• Fetal cardiac function assessment is crucial in high-risk pregnancies.
• The modified myocardial performance index (Mod-MPI) is a tool to evaluate global cardiac function.

Purpose of the Study:

• To assess fetal cardiac function using Mod-MPI in pre-eclampsia without intrauterine growth restriction.
• To compare Mod-MPI values in fetuses of pre-eclamptic mothers with normal controls.

Main Methods:

• A cross-sectional study included 72 fetuses (26-40 weeks' gestation).
• Groups comprised 40 controls, 15 mild pre-eclampsia, and 17 severe pre-eclampsia.
• Two-dimensional and Doppler fetal echocardiography were used to calculate Mod-MPI, excluding cardiac anomalies.

Main Results:

• Mean Mod-MPI values were similar across all groups (0.43-0.44).
• Fetuses of severely pre-eclamptic mothers had lower aortic peak systolic velocity (PSV), mitral E-wave, and A-wave peak velocities compared to controls and mild pre-eclampsia.
• P-value for Mod-MPI comparison was 0.680.

Conclusions:

• Fetal global myocardial function, assessed by Mod-MPI, remains unchanged in mild or severe pre-eclampsia.
• Reduced mitral inflow and aortic outflow velocities in severe pre-eclampsia suggest increased cardiac afterload rather than intrinsic cardiac dysfunction.