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Updated: Jun 18, 2026
Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
Published on: June 29, 2013
The role of the Mod-MPI in identifying cardiac dysfunction in FGR fetuses stratified by umbilical artery flow
Tuğçe Arslanoğlu1, Kübra Kurt Bilirer2, Sezin Uludağ3
1Obstetrics and Gynecology Clinic, Department of Perinatology, University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey. drtugcetunc@gmail.com.
Background:
Fetal growth restriction (FGR) is a major cause of perinatal morbidity and mortality. In patients with absent end-diastolic flow (AEDF) in the umbilical artery, placental insufficiency is typically severe, and adverse neonatal outcomes are common. The modified myocardial performance index (Mod-MPI) provides a noninvasive assessment of global fetal cardiac function; however, its relationship with Doppler findings and perinatal outcomes in patients with FGR remains under investigation.
Methods:
This prospective observational study included 217 singleton pregnancies between 24 + 0 and 36 + 0 weeks of gestation. Among these, 103 fetuses were diagnosed with FGR and subdivided on the basis of the presence (n = 47) or absence (n = 56) of AEDF. The control group included 114 gestational age-matched fetuses with normal growth and Doppler findings. Left ventricular Mod-MPI and cardiac time intervals were measured via a standardized pulsed-wave Doppler technique on the basis of valvular motion timing. The mitral inflow E- and A-wave velocities were also recorded. Perinatal outcomes such as gestational age at delivery, birth weight, 5-minute Apgar score, and NICU admission were compared.
Results:
Although the mean Mod-MPI values were not significantly different between the groups (p = 0.38), AEDF-positive fetuses had shorter ejection times and significantly lower mitral E and A velocities (p < 0.001). These findings indicate impaired diastolic function. Compared with other groups, AEDF-positive fetuses were delivered earlier, had lower birth weights, and had higher NICU admission rates (p < 0.01).
Conclusions:
In fetuses with FGR, the presence of AEDF is associated with early signs of cardiac dysfunction and poor perinatal outcomes. While the mean Mod-MPI may not differ markedly, its components reflect significant hemodynamic compromise. Mod-MPI may be a useful adjunct for monitoring fetal well-being in cases of severe placental insufficiency.
