Prospective Evaluation of Automated Right and Left Ventricular Myocardial Performance Index in Late-Onset Fetal Growth Restriction.

OBJECTIVES

To evaluate automated right- and left-ventricular myocardial performance index (Mod-MPI) using the Samsung Hera W10 (MPI+™) system in fetuses with late-onset fetal growth restriction (FGR) and to explore its association with Doppler parameters and perinatal outcomes.

METHODS

This prospective study included 177 singleton pregnancies between 32 and 39 weeks of gestation-87 with late-onset FGR and 90 gestational-age-matched controls. Fetal echocardiography and Doppler examinations were performed using the Samsung Hera W10 system with integrated MPI+™ software. Automated right and left Mod-MPI, atrioventricular valve E/A ratios, and Doppler indices were recorded. Neonatal outcomes were analyzed in relation to MPI measurements.

RESULTS

Right-ventricular MPI and isovolumic contraction time (ICT) were significantly increased in FGR fetuses compared with controls (p = .001), whereas left-ventricular MPI showed no significant difference. Umbilical artery PI and RI were higher, and CPR and umbilical peak systolic velocity were lower in FGR. Right-sided MPI correlated negatively with gestational age, birth weight, and Apgar scores.

CONCLUSION

Automated right-ventricular Mod-MPI provides a reproducible, objective indicator of early cardiac dysfunction in late-onset FGR. Elevation of right-sided MPI and prolongation of contraction time may reflect early myocardial adaptation preceding classical Doppler deterioration.