Use of the myocardial performance index as a prognostic indicator of adverse fetal outcome in poorly controlled gestational diabetic pregnancies

What is known about the topic?Fetal complications in gestational diabetes without microvascular complications are related to fetal hyperinsulinism. Our present prenatal surveillance techniques in diabetic pregnancies are neither appropriate nor sufficient as a monitoring tool. Impaired cardiac funct...

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Bibliographic Details
Published in:Prenatal diagnosis 2014-12, Vol.34 (13), p.1301-1306
Main Authors: Bhorat, Ismail E., Bagratee, Jayanthilall S., Pillay, Morgan, Reddy, Tarylee
Format: Article
Language:English
Subjects:
Adult
Cross-Sectional Studies
Diabetes, Gestational - physiopathology
Female
Fetal Heart - physiopathology
Heart Function Tests
Humans
Pregnancy
Pregnancy Outcome
Prospective Studies
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Summary:What is known about the topic?Fetal complications in gestational diabetes without microvascular complications are related to fetal hyperinsulinism. Our present prenatal surveillance techniques in diabetic pregnancies are neither appropriate nor sufficient as a monitoring tool. Impaired cardiac function in fetuses of diabetic pregnancies has been documented, but no link to adverse outcome has been demonstrated. What this study adds to the topic?This study has established an association between fetal cardiac dysfunction and abnormal fetal outcomes in poorly controlled gestational diabetic pregnancies. There seems to be an association between severity of the myocardial performance index elevation and rates of abnormal outcomes. Myocardial performance index may be an attractive monitoring tool of the fetus in poorly controlled diabetic pregnancy. ABSTRACT Objective The aim of this study was to determine whether there are any changes in cardiac function in fetuses of poorly controlled gestational diabetics and whether these changes influence perinatal outcome. Methods Twenty‐nine pregnant women with severe gestational diabetes on insulin therapy in the third trimester of pregnancy were recruited and matched with 29 women with normal pregnancies (control group). Using Doppler echocardiography, the modified myocardial performance index (Mod‐MPI) and E wave/A wave peak velocities (E/A) ratios were determined. Placental resistance Doppler markers were also determined in both groups. Adverse perinatal outcome was defined as perinatal death, admission to the neonatal intensive care unit, cord pH
ISSN:0197-3851
1097-0223
DOI:10.1002/pd.4471