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OP 26.02: Myocardial performance index ( MPI ) for monitoring intrahepatic cholestasis of pregnancy ( ICP )
Author(s) -
Henry A.,
Welsh A.W.
Publication year - 2014
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.13888
Subject(s) - medicine , cholestasis of pregnancy , pregnancy , gestational age , cohort , population , fetus , prospective cohort study , reference range , obstetrics , gastroenterology , pediatrics , genetics , environmental health , biology
ObjectivesTo examine the fetal myocardial performance index (MPI) in assessing intrahepatic cholestasis of pregnancy (ICP), given the potential role of abnormal cardiac function in ICP-mediated stillbirth.MethodsMixed longitudinal and cross-sectional study of 32 women with ICP June 2012–March 2014, 11 of whom had serum bile acids (SBA) over 30 μmol/L (4× upper limit local reference range). Fetal left, right and delta MPI (LMPI, RMPI and DMPI) were obtained at each ultrasound in addition to routine fetal growth/wellbeing. Results were correlated with gestational-age (GA) adjusted reference intervals, SBA, PR interval, and fetal outcome.ResultsThe table shows results for the total cohort (51 studies in 34 fetuses) and cross-sectional data only (n = 33). LMPI mean was significantly higher in both total cohort and high BA group (but not lower BA group) than the GA adjusted population mean. There was no significant correlation between BA level and MPI or PR interval in any group. The proportion of high BA cases with LMPI, RMPI or DMPI >2SD above the GA mean was greater than for the lower BA group (NS). Serial MPI evaluation did not improve correlation.ConclusionsLMPI values were increased above population GA-adjusted mean in cholestastic pregnancy, particularly in the subset with higher bile acids. Proportion of high BA fetuses with LMPI, RMPI, and DMPI >2SD above mean appeared greater than lower BA though correlations between BA level and MPI values were not significant. A future multicenter prospective study may clarify prognostic utility of MPI in ICP