Nguyen Tran Thao Nguyen, Kotani Tomomi, Imai Kenji, Ushida Takafumi, Moriyama Yoshinori, Kobayashi Tomoko, Niimi Kaoru, Sumigama Seiji, Yamamoto Eiko, Vo Van Duc, Le Minh Tam, Le Lam Huong, Nguyen Dac Nguyen, Nguyen Vu Quoc Huy, Truong Quang Vinh, Cao Ngoc Thanh, Kikkawa Fumitaka
Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.
Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan.
Nagoya J Med Sci. 2021 May;83(2):259-268. doi: 10.18999/nagjms.83.2.259.
The aim of this study is to determine whether the myocardial performance index (MPI) is increased in fetal growth restriction (FGR) fetuses and if increased MPI is related to adverse outcomes of FGR. This is a prospective cross-sectional study. Seventy-three late-onset FGR fetuses and 97 gestational-age matched control fetuses were enrolled in this study. Fetal blood flow parameters including MPI values were measured and compared between the two groups. For the effect of severity of growth restriction on MPI value, they were also compared with < 3 and 3 - 10 centile groups. FGR fetuses were divided into two groups by favorable and adverse outcome and ultrasound parameters were compared between these two groups. Moreover, significant factors related to adverse outcomes by univariate analysis were analyzed by multivariate logistic regression analysis. Pulsatility index of umbilical arterial flow (UA-PI), MPI and amniotic fluid index in the FGR were significantly different from the control fetuses. However, no significant difference between < 3 and 3 - 10 centile groups was detected in MPI and UA-PI. The increased levels of MPI and UA-PI were independently related with adverse outcome of late-onset FGR pregnancy. In conclusion, MPI values were increased in late-onset FGR pregnancy, and the higher level of MPI could predict adverse outcome as well as the measurement of UA-PI. Clinicians should consider cardiac dysfunction in FGR through increased MPI.
本研究的目的是确定胎儿生长受限（FGR）胎儿的心肌性能指数（MPI）是否升高，以及升高的MPI是否与FGR的不良结局相关。这是一项前瞻性横断面研究。本研究纳入了73例晚发型FGR胎儿和97例孕周匹配的对照胎儿。测量并比较两组胎儿的血流参数，包括MPI值。对于生长受限严重程度对MPI值的影响，还将其与小于第3百分位数组和第3 - 10百分位数组进行比较。将FGR胎儿按良好和不良结局分为两组，并比较这两组的超声参数。此外，通过单因素分析与不良结局相关的显著因素进行多因素逻辑回归分析。FGR胎儿的脐动脉血流搏动指数（UA-PI）、MPI和羊水指数与对照胎儿有显著差异。然而，在MPI和UA-PI方面，小于第3百分位数组和第3 - 10百分位数组之间未检测到显著差异。MPI和UA-PI水平升高与晚发型FGR妊娠的不良结局独立相关。总之，晚发型FGR妊娠中MPI值升高，较高水平的MPI与UA-PI测量一样可预测不良结局。临床医生应通过升高的MPI考虑FGR中的心脏功能障碍。
