Key result
Higher prelabour left ventricular Myocardial Performance Index was associated with requiring emergency operative delivery for intrapartum fetal compromise (median 0.56 vs 0.54; P=0.007).
Why the study?
Does prelabour left ventricular Myocardial Performance Index (LVMPI) predict intrapartum fetal compromise in low-risk term pregnancies?
Cohort (n=273)
Blinded
No
Does prelabour left ventricular Myocardial Performance Index (LVMPI) predict intrapartum fetal compromise in low-risk term pregnancies?
Higher global LVMPI in term fetuses is associated with a higher risk for intrapartum fetal compromise and poorer newborn condition.
Answers are grounded in this paper and cite their sources.
Lower prelabour fetal LV function was associated with IFC; leaves open whether routine cardiac assessment aids risk stratification in low-risk term pregnancies.
OBJECTIVE: To investigate the relationship between the prelabour left ventricular Myocardial Performance Index (LVMPI) and intrapartum fetal compromise (IFC) in low-risk term pregnancies. METHODS: A blinded, prospective observational cohort study at the Mater Mother's Hospital, Brisbane, Australia. A cohort of 284 women with uncomplicated singleton pregnancies underwent fortnightly ultrasound from 36 weeks until delivery. The LVMPI was assessed by conventional Doppler ultrasound and correlated with intrapartum outcomes. The LVMPI was also correlated with other Doppler indices of fetal wellbeing. RESULTS: Two hundred and seventy-three women were included in the final analysis, the median LVMPI was higher in fetuses that required any emergency operative delivery for IFC (0.56, 0.52-0.60 versus 0.54, 0.50-0.58, p = .007). The left ventricular cardiac output (LVCO) and cerebroplacental ratio (CPR) were lower in fetuses that required any emergency operative delivery for IFC compared to those that did not (164 ± 19 ml/min/kg versus 181 ± 30 ml/min/kg, p < .001) (1.63 + 0.30 versus 1.90 + 0.50, p < .001), respectively. The LVMPI was inversely correlated with the CPR (r = -0.20, p < .01), MCA PI (r = -0.29, p < .01), and LVCO (r = -0.22, p < .01). CONCLUSIONS: Higher global LVMPI is associated with a higher risk for IFC and poorer condition of the newborn.
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Alsolai et al. (2017) conducted a cohort in Uncomplicated singleton pregnancies (n=273). Prelabour left ventricular Myocardial Performance Index (LVMPI) vs. Lower LVMPI was evaluated on Requirement of any emergency operative delivery for intrapartum fetal compromise (p=0.007). Higher prelabour left ventricular Myocardial Performance Index was associated with requiring emergency operative delivery for intrapartum fetal compromise (median 0.56 vs 0.54; P=0.007).
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