Evaluation of the Fetal Myocardial Performance Index at Mid‐Gestation for Prediction of Fetal Growth Restriction

OBJECTIVE: Fetal growth restriction (FGR) is associated with increased perinatal morbidity and mortality. The fetal myocardial performance index (MPI) has been proposed as a marker of fetal cardiovascular adaptation for FGR; thus, this study aims to evaluate whether fetal MPI measured at 20-24 gestational weeks predicts subsequent development of FGR. MATERIALS AND METHODS: This prospective cohort study was conducted at Selcuk University (Perinatology and Obstetrics outpatient clinic) between July 1, 2024 and February 1, 2025. Singleton pregnancies (18-45 years) at 20-24 weeks without fetal structural anomalies or maternal chronic disease were enrolled. A standard second-trimester ultrasound was performed, and Doppler parameters (umbilical artery, uterine artery, middle cerebral artery, ductus venosus) and MPI were recorded. Participants were followed until delivery; FGR was defined according to Delphi criteria. RESULTS: Of 329 pregnancies, 4 intrauterine fetal deaths were excluded; after excluding pregnancies complicated by gestational diabetes, 303 remained for analysis. A total of 47 fetuses developed FGR and 256 served as controls; all preeclampsia cases (n = 7) were accompanied by FGR. Median MPI was 0.40 (0.31-0.54) in the FGR group versus 0.39 (0.21-0.58) in controls, with no significant difference (p = 0.110). CONCLUSION: MPI assessed at 20-24 weeks was not useful for predicting FGR in a low-risk singleton population.