Keywords:
Cardiac, Cardiovascular system, Foetal imaging, Obstetrics (Pregnancy / birth / postnatal period), Ultrasound-Colour Doppler, Ultrasound-Power Doppler, Ultrasound-Spectral Doppler, Observer performance, Outcomes analysis, Foetus, Obstetrics, Prospective, Case-control study, Performed at one institution
Authors:
A. Damodaran Nampoothiry1, P. D. J. Deevimeenal2, K. Gopinathan2, D. K. GEETHA2, D. B. Y. Akash Kumar2, R. Prasan2; 1Chennai, Tamil Nadu/IN, 2Chennai/IN
DOI:
10.26044/ecr2020/C-07423
Purpose
Incidence of gestational diabetes mellitus (GDM) varies globally from 2% to 14%.1 In India GDM is emerging as a major public health problem. The prevalence of GDM among urban population of India has been reported as 16% to 17.8%.2 Babies of diabetic mothers are prone to many neonatal and perinatal complications like neonatal hypoglycaemia and hyperbilirubinemia and contractility abnormalities of the cardiac muscle.
Myocardial performance index (MPI) is a Doppler-derived time interval index which has been proposed as a useful predictor of global cardiac function. By combining both systolic and diastolic cardiac performance MPI describes cardiac function. MPI or the Tei index is defined as the sum of the isovolumetric contraction time (ICT) and isovolumetric relaxation time (IRT) divided by ejection time (ET).3-6 ICT is measured from closure of the mitral valve (MV) to opening of the aortic valve (AV), IRT is measured from closure of the AV to opening of the MV and ET is measured from opening to closure of the AV. ICT & IRT reflects the systolic and diastolic function of the heart respectively(Fig1). Because of its simplicity, non-invasiveness, straightforwardness and reproducibility, MPI is being investigated for its role in determining cardiac performance.6-12 Fig. 1
Fig. 1: Three variables ICT,IRT and ET has to be obtained and MPI can be calculated as MPI = (ICT + IRT)/ET.
Aim of our study is to evaluate the foetal left ventricular function by performing modified myocardial performance index (Mod-MPI) in pregnant women with pregestational and gestational diabetes mellitus, comparing it with healthy controls and to predict the adverse perinatal outcome.