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Updated: Mar 20, 2026
Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
Published on: June 29, 2013
Assessment of modified myocardial performance index in foetuses with growth restriction
Carolina Pacheco Silva1, Edward Araujo Júnior2, Marina Maccagnano Zamith3
1Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil.
Insights
The modified myocardial performance index (Mod-MPI) did not show significant differences between fetuses with appropriate growth and those with fetal growth restriction. This index is a feasible and reproducible method for assessing fetal well-being.
Area of Science:
- Perinatology
- Fetal Cardiology
- Medical Imaging
Background:
- Fetal growth restriction (FGR) is a significant concern in high-risk pregnancies.
- Assessing fetal well-being in FGR requires reliable diagnostic tools.
- The modified myocardial performance index (Mod-MPI) is a potential echocardiographic marker.
Purpose of the Study:
- To evaluate the modified myocardial performance index (Mod-MPI) in fetuses with growth restriction.
- To compare Mod-MPI values between fetuses with and without growth restriction.
Main Methods:
- A prospective cross-sectional case-control study included 76 fetuses (24-34 weeks gestation).
- Fetuses were categorized into appropriate for gestational age, mild FGR (3rd-10th percentile), and severe FGR (<3rd percentile).
- Mod-MPI was measured using spectral Doppler in the aortic lateral wall; umbilical artery Doppler was normal in all cases.
Main Results:
- Mean Mod-MPI values were similar across all groups: 0.32 ± 0.05 (appropriate), 0.35 ± 0.05 (mild FGR), and 0.36 ± 0.06 (severe FGR) (p=0.072).
- No statistically significant difference in Mod-MPI was observed between groups.
- High intra- and inter-observer reproducibility was confirmed (ICC=0.726 and 0.760).
Conclusions:
- Mod-MPI did not significantly differentiate fetuses with FGR from those with appropriate growth.
- Mod-MPI is a feasible and reproducible echocardiographic technique for fetal assessment.
- Further research may explore other applications or modifications of MPI in FGR.
Aim:
To evaluate the modified myocardial performance index (Mod-MPI) in foetuses with growth restriction and compare this index with appropriate for gestational age foetuses.
Material And Methods:
A prospective cross-sectional case-control study was conducted involving 76 singleton foetuses between 24 and 34 weeks of gestation divided into three groups (24 appropriate growth foetuses, 30 foetuses with estimated weight between the 3rd and 10th percentiles and 22 foetuses with estimated weight < 3rd percentile, according to the Hadlock table). The Mod-MPI was obtained in the plane of the four chamber view, and the spectral Doppler sample volume was placed in the lateral wall of the aorta, close to the mitral valve. Doppler of umbilical artery was normal in all cases. Analysis of variance (ANOVA) was used to compare the groups and the intra-class correlation coefficient (ICC) was used to assess intra- and inter-observer reproducibility.
Results:
The mean Mod-MPI in the groups of appropriate for gestational age, estimated weight between the 3rd and 10th percentiles, and estimated weight < 3rd percentile was 0.32 +/- 0.05, 0.35 +/- 0.05 and 0.36 +/- 0.06, respectively; there was no statistical difference between the groups (p = 0.072). There was good intra- and inter-observer reproducibility (ICC = 0.726 and 0.760, respectively).
Conclusion:
Mod-MPI was not significantly different between foetuses appropriate for gestational age and those with growth restriction. Mod-MPI proved to be a feasible and reproducible technique.
