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Use of the myocardial performance index as a prognostic indicator of adverse fetal outcome in poorly controlled gestational diabetic pregnancies.
MedLine Citation:
PMID:  25088046     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether there are any changes in cardiac function in fetuses of poorly controlled gestational diabetics and whether these changes influence perinatal outcome.
METHODS: Twenty nine pregnant women with severe gestational diabetes on insulin therapy in the 3(rd) trimester of pregnancy were recruited and matched with 29 women with normal pregnancies (control group). Using Doppler echocardiography the modified myocardial performance index (Mod-MPI) and E- wave/A-wave peak velocities (E/A)ratios were determined. Placental resistance Doppler markers were also determined in both groups. .Adverse perinatal outcome was defined as perinatal death, admission to the NICU, cord pH <7.15, 5-minute Apgar score <7 and presence of cardiomyopathy.
RESULTS: The median Mod-MPI was increased (0.59 vs 0.38; p <0.0001) and the E/A ratio was decreased (0.65 vs 0.76; p <0.0001) in fetuses of diabetic mothers compared with controls. An MPI > 0.52 had a sensitivity of 100% (95%CI 85%-100%) and specificity of 92% (95% CI 70% -92%) for prediction of adverse perinatal outcome, including one stillbirth and one neonatal death. No abnormal outcomes occurred in the control group.
CONCLUSIONS: There is significant impairment of cardiac function in fetuses of poorly controlled gestational diabetics. Mod-MPI and E/A ratio have the potential to improve fetal surveillance in diabetic pregnancies. This article is protected by copyright. All rights reserved.
Authors:
I E Bhorat; J S Bagratee; M Pillay; T Reddy
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-8-1
Journal Detail:
Title:  Prenatal diagnosis     Volume:  -     ISSN:  1097-0223     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-8-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
This article is protected by copyright. All rights reserved.
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