Modified myocardial performance index (Mod-MPI) as a Doppler-derived marker for fetal cardiac dysfunction in diabetic and preeclamptic pregnancies

Abstract Background Fetal metabolism is altered by maternal hyperglycaemia. The most likely structure in the fetal heart to be impacted by hyperglycemia is the myocardial tissue. There is a correlation between utero-placental inadequate perfusion and elevated umbilical resistance in pre-eclamptic pregnancies, which ultimately impacts the heart’s development. Therefore, a higher fetal cardiac afterload brought on by an increased placental vascular resistance may result in a changed fetal cardiac function. The objective of the study is to compare pregnant women with preeclampsia and gestational diabetes to healthy controls in order to assess the effects of the fetal Mod-MPI. Methods This cross-sectional study was conducted on a total of 106 pregnant women aged from 19 to 43 years old & the gestational age from 20th week of gestation to 38th week of gestation, singleton pregnancies who attended the routine antenatal scan or referred for fetal echocardiography, The patients were divided into three groups, control group (n = 53): Healthy women with no pregnancy related complications, GDM group (n = 18) and Preeclampsia group (n = 35). Aim of the Study Is to compare pregnant women with preeclampsia and gestational diabetes to healthy controls in order to assess the effects of the fetal Modified Myocardial Performance Index (Mod-MPI). We hypothesized that Mod-MPI would be significantly elevated in fetuses of GDM and preeclamptic pregnancies compared to controls. Results The Mod-MPI exhibited significant differences among the groups. Both GDM and preeclampsia groups had higher mean Mod-MPI values (0.67 ± 0.12 and 0.65 ± 0.16, respectively), indicative of compromised cardiac function, compared to the control group with a lower Mod-MPI of 0.47 ± 0.06 ( p < 0.001). No significant difference was observed between the GDM and preeclampsia groups. Conclusion Mod-MPI appears to be a useful adjunctive parameter for the assessment of fetal cardiac function in pregnancies complicated by gestational diabetes mellitus and preeclampsia. Key findings reveal that both conditions are associated with significant alterations in cardiac function parameters, including higher Mod-MPI values, indicative of impaired cardiac function compared to healthy controls.