Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
Department of Obstetrics and Gynecology, Division of Perinatology, University of Health Sciences, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
J Matern Fetal Neonatal Med. 2023 Dec;36(1):2192322. doi: 10.1080/14767058.2023.2192322.
To assess the epicardial fat thickness (EFT) and modified myocardial performance index (Mod-MPI) measurements in fetuses at pregnant women with preterm prelabor rupture of membranes (pPROM) and compare them to healthy pregnant women's fetuses.
Forty patients who presented to our clinic at 24-36 + 6 gestational weeks and were diagnosed with pPROM were included in the patient group. During the same period, 40 healthy pregnant women at similar gestational weeks were randomly selected as the control group.
The pPROM and control groups were similar in terms of demographics. In the pPROM group, EFT, Mod-MPI, and isovolumetric contraction(ICT) and relaxation times(IRT) were significantly higher and ejection time (ET) was significantly lower compared to the control group. In addition, Mod-MPI -scores, IRT -scores, ICT -scores were significantly higher and ET -scores was significantly lower in the pPROM. According to the ROC analysis, the optimal cutoff value of EFT was calculated as 1.55 mm, with 68% sensitivity and 71% specificity (AUC: 0.718, 95% CI: 0.550-0.786, = .018) for predicting NICU requirement and the optimal cutoff value of EFT was calculated as 1.55 mm with 72% sensitivity and 73% specificity (AUC: 0.726, 95% CI: 0.556-0.896, = .015) for predicting medication use in the pPROM group.
This study revealed differences in the EFT and Mod-MPI measurements of the fetuses of pregnant women with pPROM. Considering that EFT is an important energy source for the myocardium, as well as an endocrine structure in which inflammatory and anti-inflammatory markers are secreted, it is recommended to be evaluated in inflammatory conditions such as pPROM.
评估患有早产胎膜早破（pPROM）的孕妇胎儿的心外膜脂肪厚度（EFT）和改良心肌做功指数（Mod-MPI）测量值，并将其与健康孕妇的胎儿进行比较。
将 40 名在 24-36+6 孕周就诊并被诊断为 pPROM 的患者纳入患者组。同期，随机选择 40 名相似孕周的健康孕妇作为对照组。
pPROM 组和对照组在人口统计学方面相似。在 pPROM 组中，EFT、Mod-MPI 以及等容收缩期（ICT）和等容舒张期（IRT）明显高于对照组，而射血时间（ET）明显低于对照组。此外，Mod-MPI 评分、IRT 评分、ICT 评分明显升高，ET 评分明显降低。根据 ROC 分析，EFT 的最佳截断值计算为 1.55mm，灵敏度为 68%，特异性为 71%（AUC：0.718，95%CI：0.550-0.786， = 0.018），预测 NICU 需求；EFT 的最佳截断值计算为 1.55mm，灵敏度为 72%，特异性为 73%（AUC：0.726，95%CI：0.556-0.896， = 0.015），预测 pPROM 组药物使用。
本研究揭示了 pPROM 孕妇胎儿 EFT 和 Mod-MPI 测量值的差异。考虑到 EFT 是心肌的重要能量来源，也是分泌炎症和抗炎标志物的内分泌结构，建议在炎症状态如 pPROM 中进行评估。
