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Sequence of changes in myocardial performance index in relation to aortic isthmus and ductus venosus Doppler in fetuses with early‐onset intrauterine growth restriction
Author(s) -
CruzMartinez R.,
Figueras F.,
BenavidesSerralde A.,
Crispi F.,
HernandezAndrade E.,
Gratacos E.
Publication year - 2011
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.8903
Subject(s) - ductus venosus , medicine , intrauterine growth restriction , fetus , percentile , cardiology , in utero , umbilical artery , gestation , pregnancy , obstetrics , statistics , genetics , mathematics , biology
Objective To explore the sequence of changes in myocardial performance index (MPI) and aortic isthmus (AoI) and ductus venosus (DV) flow in fetuses with early‐onset intrauterine growth restriction (IUGR). Methods MPI and AoI and DV pulsatility indices (PI) were evaluated every 1–7 days in a cohort of IUGR fetuses with abnormal umbilical artery Doppler PI (> 95 th percentile) delivered before 34 weeks' gestation. The longitudinal changes were analyzed in the last 30 days before delivery by multilevel and survival analysis. Results A total of 430 scans were performed on 115 IUGR fetuses. MPI, AoI‐PI and DV‐PI showed increases with the progression of fetal deterioration throughout the follow‐up study period, but the rates of progression were different. On average, MPI, AoI‐PI and DV‐PI crossed the 95 th percentile at 26 days, 12 days and 5 days before delivery, respectively. At the last examination before delivery, the proportion of increased MPI (70.4%) was significantly higher than that of abnormal AoI‐PI (55.7%; P < 0.01) and DV‐PI (47.8%; P < 0.01). Conclusion In early‐onset IUGR, MPI and AoI and DV Doppler indices all increase but at different rates, which could provide the basis for further research on their use for improving in‐utero monitoring and prediction of long‐term outcome. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.