Foetal Modified Myocardial Performance Index as a Predictor of Pregnancy Outcome in Gestational Diabetic Mothers: A Prospective Observational Study

Introduction: Foetuses of mothers with Gestational Diabetes Mellitus (GDM) are at increased risk for cardiac complications even with metabolic control. Conventional Doppler methods often fail to detect early cardiac dysfunction in these cases. The Modified Myocardial Performance Index (Mod-MPI) offers a sensitive and non-invasive tool for early detection of foetal cardiac impairment in GDM pregnancies. Aim: To assess foetal cardiac function using Mod-MPI by doppler in gestational diabetic mothers in early third trimester (28-32 weeks) and to evaluate its utility in prediction of perinatal outcome. Materials and Methods: The present prospective observational study was conducted at VMMC and Safdarjung Hospital, New Delhi, India, from November 2017 to November 2018. A total of 30 singleton pregnant females in the third trimester (28-32 weeks) with a known history of GDM and 30 singleton pregnant females in the third trimester with no history of GDM were included. Patients with multiple pregnancy intrauterine growth retardation, Pre GDM, congenital anomalies, history of cardiac disease or hypertension were excluded from the study. Using doppler ultrasonography, the Mod-MPI was calculated in the foetal left ventricle. Multiple statistical tests and Receiver Operating Characteristic (ROC) analysis was used to determine the optimal Mod-MPI cut-off for predicting adverse foetal outcomes. A p-value