EC Gynaecology

Research Article Volume 14 Issue 1 - 2025

Application of Cardiovascular Profile Score and Myocardial Performance Index to Predict Perinatal Mortality in Fetus with Intrauterine Growth Restriction Followed Up in a University Hospital in Brazil during 2022

Rayra Amana Macêdo Maciel1*, Vanessa Tayer Nogueira2, Rebeca Santos Garcia3, Frederico Timm Rodrigues de Sousa3, Ana Paula Brum Miranda Lopes4 and Henrique Vitor Leite5

1Mestrado em Saúde da Mulher, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil

2Médico Residente, Hospital Sofia Feldman, Belo Horizonte, MG, Brazil

3Médico Residente, Departamento de Ginecologia e Obstetrícia, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil

4Médico Assistente, Departamento de Ginecologia e Obstetrícia, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil

5Professor e Médico Assistente, Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil

*Corresponding Author: Rayra Amana Macêdo Maciel, Mestrado em Saúde da Mulher, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Received: August 10, 2024; Published: February 07, 2025



Objective: To assess whether fetal cardiovascular score and myocardial performance index (MPI) are associated with worse neonatal outcomes in fetuses diagnosed with intrauterine growth restriction (IUGR) followed at the Clinics Hospital of UFMG in 2022.

Methodology: This is a prospective and longitudinal study that included patients followed at the high-risk prenatal care at the Clinics Hospital of UFMG for IUGR. The fetuses were monitored with Doppler velocimetry, and the timing of delivery was guided according to institutional protocol. Fetal cardiac function was evaluated using the fetal cardiovascular score and MPI, and perinatal outcomes were assessed. Statistical association tests included calculation of odds ratio (OR), Fisher's exact test, Student's t, and Pearson's correlation test.

Results: It was identified associations between an increased risk of death for cases where there were alterations in the percentile of umbilical artery doppler, fetal cardiovascular score, and ductus venosus. Associations were also observed between the outcome of death and lower mean CPR percentiles, lower ICT values, lower gestational ages at birth, as well as associations with higher mean percentiles of uterine artery Doppler and TE values. An association was also identified between neonatal death and alteration of MPI parameters, as well as the correlation of this and lower Apgar scores at 5 minutes.

Conclusion: The parameters of fetal cardiovascular score and myocardial performance index, as well as alterations in fetal Doppler velocimetry, are associated with worse neonatal outcomes.

 Keywords: Intrauterine Growth Restriction; Fetal Echocardiography; Fetal Doppler Velocimetry; Huhta's Cardiovascular Score; Myocardial Performance Index

  1. Figueras F and Gratacos E. “Stage‐based approach to the management of fetal growth restriction”. Prenatal Diagnosis7 (2014): 655-659.
  2. Figueras F and Gratacós E. “Update on the diagnosis and classification of fetal growth restriction and proposal of a stage-based management protocol”. Fetal Diagnosis and Therapy2 (2014): 86-98.
  3. Figueras F and Gratacos E. “An integrated approach to fetal growth restriction”. Best Practice and Research Clinical Obstetrics and Gynaecology 38 (2017): 48-58.
  4. Melamed N., et al. “FIGO (international Federation of Gynecology and obstetrics) initiative on fetal growth: best practice advice for screening, diagnosis, and management of fetal growth restriction”. International Journal of Gynaecology and Obstetrics1 (2021): 3-57.
  5. Gordijn SJ., et al. “Consensus definition of fetal growth restriction: a Delphi procedure”. Ultrasound in Obstetrics and Gynecology3 (2016): 333-339.
  6. Lees CC., et al. “ISUOG Practice Guidelines: diagnosis and management of small-for-gestational-age fetus and fetal growth restriction”. Ultrasound in Obstetrics and Gynecology2 (2020): 298-312.
  7. Mappa I., et al. “Cardiac function in fetal growth restriction”. Minerva Obstetrics and Gynecology4 (2021): 423-434.
  8. Friedman D., et al. “Fetal cardiac function assessed by Doppler myocardial performance index (Tei Index)”. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology1 (2003): 33-36.
  9. Huhta JC. “Guidelines for the evaluation of heart failure in the fetus with or without hydrops”. Pediatric Cardiology3 (2004): 274-286.
  10. Kim SM and Ye SY. “Evaluation of the fetal left ventricular myocardial performance index (MPI) by using an automated measurement of doppler signals in normal pregnancies”. Diagnostics2 (2021): 358.
  11. Larsen LU., et al. “Systolic myocardial velocity alterations in the growth‐restricted fetus with cerebroplacental redistribution”. Ultrasound in Obstetrics and Gynecology1 (2009): 62-67.
  12. C Tei. “New non-invasive index for combined systolic and diastolic ventricular function”. Journal of Cardiology2 (1995): 135-136.
  13. Hernandez-Andrade E., et al. “Evaluation of conventional Doppler fetal cardiac function parameters: E/A ratios, outflow tracts, and myocardial performance index”. Fetal Diagnosis and Therapy1-2 (2012): 22-29.
  14. Figueras F., et al. “Cardiac function monitoring of fetuses with growth restriction”. European Journal of Obstetrics and Gynecology and Reproductive Biology 110.2 (2003): 159-163.
  15. Hernandez‐Andrade E., et al. “Contribution of the myocardial performance index and aortic isthmus blood flow index to predicting mortality in preterm growth‐restricted fetuses”. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology4 (2009): 430-436.
  16. Mäkikallio K., et al. “Human fetal cardiovascular profile score and neonatal outcome in intrauterine growth restriction”. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology 1 (2008): 48-54.
  17. Wieczorek A., et al. “Prediction of outcome of fetal congenital heart disease using a cardiovascular profile score”. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology3 (2008): 284-288.
  18. Öcal DF., et al. “Utility of the modified myocardial performance index in growth‐restricted fetuses”. Echocardiography10 (2019): 1895-1900.

Rayra Amana Macêdo Maciel., et al. "Application of Cardiovascular Profile Score and Myocardial Performance Index to Predict Perinatal Mortality in Fetus with Intrauterine Growth Restriction Followed Up in a University Hospital in Brazil during 2022". EC Gynaecology 14.2 (2025): 01-08.