Key result
Idiopathic mildly increased amniotic fluid index was associated with a significantly higher fetal left myocardial performance index compared to matched healthy controls (0.52 vs 0.41, P<.0001).
Why the study?
To evaluate modified myocardial performance index, or Tei index, in fetuses of pregnancies with idiopathic mildly increased amniotic fluid index.
Does idiopathic mildly increased amniotic fluid index affect fetal myocardial performance index compared to healthy controls?
Case-Control (n=50)
Does idiopathic mildly increased amniotic fluid index affect fetal myocardial performance index compared to healthy controls?
Pregnancies with idiopathic mildly increased amniotic fluid index are associated with significantly increased fetal myocardial performance index in both ventricles, suggesting altered fetal cardiac function.
Mildly increased AFI was associated with higher fetal MPI; hypothesis-generating and should not yet change practice.
PURPOSE: To evaluate modified myocardial performance index (MPI), or Tei index, in fetuses of pregnancies with idiopathic mildly increased amniotic fluid index (AFI). METHODS: We studied 25 cases (24-40 weeks) with idiopathic mildly increased AFI, and 25 gestational age- and fetal gender-matched healthy controls. Fetal echocardiographic variables and Doppler-derived indices were recorded, including left and right MPI, left isovolumetric contraction time (IVCT), left ejection time (ET), left isovolumetric relaxation time (IVRT), aortic and pulmonary arterial peak systolic velocity (PSV), left and right E/A ratios, middle cerebral artery (MCA) pulsatility index (PI), and umbilical artery (UA) PI. RESULTS: The mean left MPI (0.52 vs 0.41, P < .0001) and right MPI (0.50 vs 0.42, P < .001) were higher, and mean IVCT (37.7 vs 25.9, P < .0001) was longer in cases than in controls. However, there were no significant differences between the two groups in IVRT (45.2 vs 43.2, P = .381), ET (160.2 vs 170.0, P = .079), aortic PSV (P = .073), left E/A (P = .080), pulmonary artery PSV (P = .061), right E/A (P = .054), MCA PI (P = .259), UA PI (P = .685), and cerebroplacental ratio (P = .645). CONCLUSION: Pregnancies with idiopathic mildly increased AFI were associated with a significant increase in the fetal MPI of both left and right ventricles.
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Attar et al. (2020) conducted a case-control in Idiopathic mildly increased amniotic fluid volume (n=50). Idiopathic mildly increased amniotic fluid index vs. Healthy controls was evaluated on Left myocardial performance index (MPI) (p=<.0001). Idiopathic mildly increased amniotic fluid index was associated with a significantly higher fetal left myocardial performance index compared to matched healthy controls (0.52 vs 0.41, P<.0001).
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