title: Fetal cardiac function measured by myocardial performance index of small-for-gestational age fetuses.
abstract: OBJECTIVE
  The aim of this study was to demonstrate the changes of right and left myocardial performance indices (MPI) in small-for-gestational age (SGA) fetuses during 28-40 weeks of gestation.
  
  
  METHODS
  Singleton pregnant women during 28-40 weeks of gestation were enrolled. Estimated fetal weight was used to classify the subjects into appropriate-for-gestational age (AGA) and SGA groups. The Doppler indices of umbilical and middle cerebral arteries, including amniotic fluid index, were used to distinguish constitutional SGA (both normal Doppler indices and amniotic fluid index) from intrauterine growth restriction (IUGR) fetuses (abnormal Doppler indices and/or oligohydramnios). MPI was obtained and compared between the groups. Inter- and intra-observer variations were also assessed.
  
  
  RESULTS
  Fifty women had AGA fetuses whereas another 50 cases had SGA fetuses (41 constitutional SGA and nine IUGR). Right MPI in AGA fetuses was constant whereas left MPI was slightly increased. The MPI of SGA fetuses were significantly greater than those of AGA fetuses starting from 30 weeks gestation until delivery (P < 0.01 and <0.05 in right and left side, respectively). Subgroup analysis demonstrated right and left MPI of IUGR fetuses increased with advancing gestation and were significantly greater than those of constitutional SGA and AGA fetuses, which appeared to be similar. The reproducibility of the test was high.
  
  
  CONCLUSIONS
  In SGA fetuses, the MPI of right and left ventricles was significantly increased with advancing gestation compared to AGA cases.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Suphang
authors.initials: S
authors.lastname: Chawengsettakul
authors.forename: Kusol
authors.initials: K
authors.lastname: Russameecharoen
authors.forename: Prapat
authors.initials: P
authors.lastname: Wanitpongpan
mesh_terms: D000328:Adult; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000503:physiopathology*; D020567:Fetal Weight; D005865:Gestational Age; D006801:Humans; D008137:Longitudinal Studies; D015588:Observer Variation; D011247:Pregnancy; D011446:Prospective Studies; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right; D055815:Young Adult
keywords: intrauterine growth restriction; myocardial performance index; small-for-gestational age fetus