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.