Diagnostic value of the myocardial performance index and doppler parameters in detecting fetal growth restriction in pregnancies complicated by hypertensive disorders.

BACKGROUND

Hypertensive disorders in pregnancy (HDP) are conditions that may affect fetal growth and development. This study aimed to assess the diagnostic value of the myocardial performance index (MPI) and Doppler parameters in identifying fetal growth restriction (FGR) in HDP. Further, this study also sought to analyze the correlation between fetal echocardiographic parameters and pregnancy outcomes.

METHODS

A total of 202 pregnant women at Xiangyang No. 1 People's Hospital were recruited for this prospective study and allocated to three groups: the healthy control group (n=95), HDP without FGR group (n=75), and HDP with FGR group (n=32). Fetal cardiac assessments included measurements of the MPI, umbilical artery pulsatility index (UA-PI), and middle cerebral artery pulsatility index (MCA-PI), with additional fetal and maternal clinical data collected. Statistical analyses were performed to compare these parameters among groups, and correlation analyses were performed to examine the relationships between birth weight and Doppler, clinical, and cardiac parameters.

RESULTS

The HDP with FGR group exhibited a significantly higher MPI (0.48±0.08 vs. 0.42±0.05, P<0.001) and UA-PI (1.23±0.20 vs. 0.89±0.14, P<0.001) compared to the control group. Significant negative correlations were observed between birth weight and the MPI (r=-0.405, P=0.036), as well as between birth weight and the UA-PI (r=-0.317, P=0.039). In the receiver operating characteristic (ROC) curve analysis distinguishing HDP with FGR from HDP with normal fetal growth, estimated fetal weight (EFW) and the UA-PI demonstrated the highest discriminative power [area under the curve (AUC) =0.86 for both], followed by the MPI [AUC =0.78, 95% confidence interval (CI): 62.0-94.4%].

CONCLUSIONS

HDP with FGR was found to be associated with significant fetal cardiac dysfunction and increased placental resistance. The MPI and UA-PI could serve as effective quantitative markers for detecting FGR in hypertensive pregnancies. The significant correlation between these parameters and birth weight supports their clinical utility for early detection and targeted monitoring in high-risk pregnancies.