Fetuses of mothers with poorly controlled gestational diabetes had significantly increased median modified myocardial performance index compared to controls (0.59 vs 0.38; p<0.0001).
Case-Control (n=58)
Does the modified myocardial performance index (Mod-MPI) predict adverse perinatal outcomes in fetuses of poorly controlled gestational diabetic pregnancies?
Fetal cardiac function is significantly impaired in poorly controlled gestational diabetes, and a modified myocardial performance index >0.52 accurately predicts adverse perinatal outcomes.
Tasa de eventos absoluta: 0.59% vs 0.38%
valor p: p=< 0.0001
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 0.52 had a sensitivity of 100% 95% confidence interval (CI) 85-100% and specificity of 92% (95% CI 70-92%) for prediction of adverse perinatal outcome, including one stillbirth and one neonatal death. No abnormal outcomes occurred in the control group. CONCLUSIONS: There is significant impairment of cardiac function in fetuses of poorly controlled gestational diabetics. Mod-MPI and E/A ratio have the potential to improve fetal surveillance in diabetic pregnancies.
Bhorat et al. (Fri,) conducted a case-control in Severe gestational diabetes (n=58). Poorly controlled gestational diabetes vs. Normal pregnancies was evaluated on Median modified myocardial performance index (Mod-MPI) (p=< 0.0001). Fetuses of mothers with poorly controlled gestational diabetes had significantly increased median modified myocardial performance index compared to controls (0.59 vs 0.38; p<0.0001).