Myocardial performance index in fetal anemia

Area of Science:

• Perinatal Medicine
• Fetal Cardiology
• Maternal-Fetal Medicine

Background:

• Fetal anemia, particularly due to maternal anti-D alloimmune disease, poses significant risks to fetal well-being.
• Assessing fetal cardiac function is crucial for managing pregnancies complicated by anemia.

Purpose of the Study:

• To investigate the relationship between fetal myocardial performance index (MPI) and hemoglobin (Hb) levels in singleton pregnancies at risk for fetal anemia.
• To determine if ultrasound-assessed MPI can serve as an indicator of fetal anemia severity.

Main Methods:

• A prospective study involving singleton pregnancies at risk of fetal anemia.
• Fetal left and right ventricle MPIs were assessed via ultrasound within 72 hours of cordocentesis.
• Zeta-scores for MPI and Hb levels were calculated and analyzed for correlation using linear regression.

Main Results:

• Significant correlations were found between left ventricular (LV) MPI zeta-scores and fetal Hb zeta-scores (r=0.59, p<0.001).
• LV isovolumetric relaxation time (IRT) and ejection time (ET) also showed significant correlation with Hb levels (p=0.01 and p=0.02, respectively).
• LV isovolumetric contraction time (ICT) and right ventricle (RV) MPI did not demonstrate a significant correlation with fetal Hb levels.

Conclusions:

• Left ventricular myocardial performance is preserved and potentially enhanced in fetuses with moderate to severe anemia.
• Fetal MPI, particularly LV MPI, shows a significant correlation with hemoglobin levels, suggesting its utility in assessing fetal cardiac status in anemia.