Assessment of the Cardiac Function in Intrauterine Growth-Restricted Fetuses and Appropriate for Gestational Age Fetuses

  • Bhoomika SharmaEmail author
  • Asha Verma
  • Chandrabhan Meena
  • Anil Gurjar
  • Arpita Chakraborty
  • Ankita Srivastav
Original Article



Aim of the study is to evaluate the myocardial performance index in intrauterine growth restricted fetuses and compare this index with appropriate for gestational age fetuses.

Materials & Methods

A prospective study was conducted in S.M.S Medical College Jaipur, involving 72 singleton fetuses ≥ 28 weeks of gestation divided into two groups: 36 intrauterine growth restricted fetuses (IUGR) and 36 appropriate for gestational age fetuses (AGA). Myocardial performance index was obtained by fetal echocardiography.


The mean myocardial performance index in the IUGR fetuses and AGA fetuses was statistically significant and that was 0.62 ± 0.02 and 0.45 ± 0.01, respectively; (p value: < 0.0001). These findings suggest that IUGR induces primary cardiac changes, which could explain the increased predisposition to cardiovascular disease in adult life. This study concluded that Fetal echocardiographic parameters (MPI) identify a high risk group within the IUGR fetuses, which could be targeted for early screening of blood pressure and other cardiovascular risk factors, as well as for promoting a healthy diet and physical exercise.


Myocardial performance index Fetal echocardiography Intrauterine growth restricted fetus 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

The study has been approved by own institutional ethical committee.

Informed Consent

Informed consent was obtained from all participants in the study regarding participation in the study. Guidelines based on Declaration of Helsinki and local ethical guidelines were followed for each patient.


  1. 1.
    Demicheva E, Crispi F. Long-term follow-up of intrauterine growth restriction: cardiovascular disorders. Fetal Diagn Ther. 2014;36:143–53.CrossRefGoogle Scholar
  2. 2.
    Crispi F, Hernandez-Andrade E, Pelsers MM, et al. Cardiac dysfunction and cell damage across clinical stages of severity in growth-restricted fetuses. Am J Obstet Gynecol. 2008;199(254):e1–8.Google Scholar
  3. 3.
    Opie LH, Commerford PJ, Gersh BJ, Pfeffer MA. Controversies in ventricular remodelling. Lancet. 2006;367:356–67.CrossRefGoogle Scholar
  4. 4.
    Tsutsumi T, Ishii M, Eto G, Hota M, Kato H. Serial evaluation for myocardial performance in fetuses and neonates using a new Doppler index. Pediatr Int. 1999;41:722–7.CrossRefGoogle Scholar
  5. 5.
    Ichizuka K, Matsuoka R, Hasegawa J, et al. The Tei index for evaluation of fetal myocardial performance in sick fetuses. Early Hum Dev. 2005;81:273–9.CrossRefGoogle Scholar
  6. 6.
    Chawengsettakul S, Russameecharoen K, Wanitpongpan P. Fetal cardiac function measured by myocardial performance index of small-for-gestational agefetuses. J Obstet Gynaecol Res. 2015;41(2):222–8.CrossRefGoogle Scholar
  7. 7.
    Pérez-Cruz M, Cruz-Lemini M, Fernández MT, et al. Fetal cardiac function in late-onset intrauterine growth restriction vs small-for-gestational age, as defined by estimated fetal weight, cerebroplacental ratio and uterine artery Doppler. Ultrasound Obstet Gynecol. 2015;46(4):465–71.CrossRefGoogle Scholar
  8. 8.
    Hassan WA, Brockelsby J, Alberry M, et al. Cardiac function in early onset small for gestational age and growth restricted fetuses. Eur J Obstet Gynecol Reprod Biol. 2013;171(2):262–5.CrossRefGoogle Scholar
  9. 9.
    Nassr AA, Youssef AA, Zakherah MS, et al. Clinical application of fetal left modified myocardial performance index in the evaluation of fetal growth restriction. J Perinat Med. 2015;43(6):749–54.CrossRefGoogle Scholar

Copyright information

© Federation of Obstetric & Gynecological Societies of India 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and Gynaecology, Zenana HospitalS.M.S. Medical College JaipurKotaIndia
  2. 2.Department of Obstetrics and Gynaecology, Zenana HospitalS.M.S. Medical College JaipurJaipurIndia
  3. 3.Department of Obstetrics and Gynaecology, Zenana HospitalS.M.S. Medical College JaipurJaipurIndia

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