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Updated: Jul 8, 2026
Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
Published on: June 29, 2013
Assessment of myocardial performance index in late-onset fetal growth restriction
Tran Thao Nguyen Nguyen1, Tomomi Kotani2,3, Kenji Imai3
1Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.
Insights
The myocardial performance index (MPI) is elevated in fetuses with fetal growth restriction (FGR). Increased MPI, along with umbilical arterial pulsatility index (UA-PI), can predict adverse outcomes in late-onset FGR pregnancies.
Area of Science:
- Perinatology
- Fetal Cardiology
- Reproductive Medicine
Background:
- Fetal growth restriction (FGR) is associated with increased risks of adverse perinatal outcomes.
- Cardiac dysfunction is increasingly recognized as a component of FGR pathophysiology.
- The myocardial performance index (MPI) is a sensitive indicator of global biventricular function.
Purpose of the Study:
- To investigate whether the myocardial performance index (MPI) is elevated in fetuses with late-onset FGR.
- To determine if increased MPI is associated with adverse pregnancy outcomes in FGR.
- To explore the relationship between MPI, umbilical arterial pulsatility index (UA-PI), and FGR severity.
Main Methods:
- Prospective cross-sectional study comparing 73 late-onset FGR fetuses with 97 gestational-age matched controls.
- Fetal blood flow parameters, including MPI and UA-PI, were measured.
- FGR fetuses were stratified by growth restriction severity and pregnancy outcome (favorable vs. adverse) for comparative analysis.
Main Results:
- FGR fetuses exhibited significantly higher MPI and UA-PI values compared to controls.
- No significant differences in MPI or UA-PI were found between FGR subgroups based on growth restriction severity (<3rd vs. 3rd-10th centiles).
- Elevated MPI and UA-PI were independently correlated with adverse outcomes in late-onset FGR pregnancies.
Conclusions:
- Myocardial performance index (MPI) is increased in pregnancies complicated by late-onset FGR.
- Higher MPI levels, similar to UA-PI, serve as a predictive marker for adverse outcomes in FGR.
- Clinicians should consider assessing cardiac function using MPI in the management of FGR.
Abstract:
The aim of this study is to determine whether the myocardial performance index (MPI) is increased in fetal growth restriction (FGR) fetuses and if increased MPI is related to adverse outcomes of FGR. This is a prospective cross-sectional study. Seventy-three late-onset FGR fetuses and 97 gestational-age matched control fetuses were enrolled in this study. Fetal blood flow parameters including MPI values were measured and compared between the two groups. For the effect of severity of growth restriction on MPI value, they were also compared with < 3rd and 3rd - 10th centile groups. FGR fetuses were divided into two groups by favorable and adverse outcome and ultrasound parameters were compared between these two groups. Moreover, significant factors related to adverse outcomes by univariate analysis were analyzed by multivariate logistic regression analysis. Pulsatility index of umbilical arterial flow (UA-PI), MPI and amniotic fluid index in the FGR were significantly different from the control fetuses. However, no significant difference between < 3rd and 3rd - 10th centile groups was detected in MPI and UA-PI. The increased levels of MPI and UA-PI were independently related with adverse outcome of late-onset FGR pregnancy. In conclusion, MPI values were increased in late-onset FGR pregnancy, and the higher level of MPI could predict adverse outcome as well as the measurement of UA-PI. Clinicians should consider cardiac dysfunction in FGR through increased MPI.
