What question did this study set out to answer?

To evaluate the effects of indomethacin tocolytic treatment on fetal heart function using modified myocardial performance index.

January 10, 2026BMC Pregnancy and Childbirth0 citationsOpen Access

Evaluation of the effects of indomethacin tocolytic treatment on fetal heart using modified myocardial performance index (Mod-MPI)

BBBarış BozaIstanbul Metropolitan Municipality FEFırat ErsanIstanbul Metropolitan Municipality VAVerda Alpay

Key Result

Indomethacin tocolytic treatment does not adversely affect fetal cardiac function as measured by Mod-MPI, even in cases of tricuspid regurgitation with stable parameters.

Key Points

To evaluate the effects of indomethacin tocolytic treatment on fetal heart function using modified myocardial performance index.
Evaluation of fetal cardiac function using modified myocardial performance index (Mod-MPI)
Monitoring of tricuspid regurgitation incidence
Assessing overall heart function before and after treatment
Indomethacin treatment did not negatively affect fetal cardiac function or Mod-MPI scores
Monitoring is advised when tricuspid regurgitation occurs, provided other parameters remain stable

Structured PICO

Does indomethacin tocolytic treatment affect fetal cardiac function and modified myocardial performance index (Mod-MPI) in pregnant women with threatened preterm labor?

Population

114 pregnant women (aged 18-40 years) with singleton pregnancies between 28 and 31 weeks of gestation. The case group (n=57) had threatened preterm labor (regular uterine contractions with cervical length <25 mm). The control group (n=57) consisted of gestational age-matched women with uneventful pregnancies. Key exclusions: multiple pregnancies, fetal growth restriction, congenital anomalies, ruptured membranes, and systemic disorders (diabetes, chronic hypertension, preeclampsia).

Intervention

Indomethacin tocolytic therapy initiated with a loading dose of 100 mg administered rectally, followed by a maintenance dose of 25 mg orally every 6 hours. Total length of treatment was restricted to 48-72 hours.

Comparator

Gestational age-matched women with uneventful pregnancies who did not receive indomethacin.

Outcome

Fetal cardiac structures, modified myocardial performance index (Mod-MPI), and hemodynamic parameters assessed by echocardiography 48 hours after the initial diagnosis of threatened preterm labor (following completion of indomethacin therapy).surrogate

Short-term indomethacin tocolytic therapy (48-72 hours) does not negatively affect overall fetal cardiac function as measured by Mod-MPI, suggesting that treatment can be safely monitored rather than ceased if tricuspid regurgitation occurs.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Indomethacin treatment does not negatively affect fetal cardiac function or Mod-MPI. When tricuspid regurgitation occurs, increased monitoring is recommended rather than treatment cessation if other parameters remain stable.

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