الفهرس 
• PreeclampsiaOnly 14 pages are availabe for public view
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Abstract
Diabetic pregnancies are categorized into pre-gestational diabetes and gestational diabetes mellitus (GDM), with GDM being a common metabolic disorder caused by insulin resistance from pregnancy hormones. This condition increases the risk of adverse outcomes and can affect fetal development, particularly the myocardial tissue, leading to issues like cardiomyopathy and diastolic dysfunction due to decreased ventricular compliance, with a significant impact on the inter-ventricular septum.
Fetuses of diabetic mothers may develop functional cardiac abnormalities regardless of structural heart defects and despite good glycemic control. Additionally, conditions like preeclampsia, characterized by hypertension and proteinuria after 20 weeks of gestation, can exacerbate maternal and fetal health risks by impairing fetal cardiac function through increased uteroplacental vascular resistance and potential myocardial injury.
Cardiovascular evaluation is crucial in fetal medicine for the early detection and monitoring of cardiac dysfunctions. The Myocardial Performance Index (MPI or Tei index) is a vital tool for assessing overall cardiac function, incorporating both systolic and diastolic performance measures. However, its utility has been limited by poor reproducibility in clinical applications.
The introduction of the modified MPI (Mod-MPI) has improved reproducibility by using Doppler clicks from the aortic and mitral valves for more accurate cardiac time interval measurements. This modification significantly enhances fetal cardiac function assessment, with normal Mod-MPI values ranging from 0.35 to 0.60, demonstrating its efficacy in precisely evaluating fetal heart health.
Therefore, this study aimed to compare the fetal modified myocardial performance index (Mod. MPI) between fetuses of pregnant women with gestational diabetes mellitus (GDM), preeclampsia, and healthy controls.
This cross-sectional study included 18 pregnant women diagnosed with GDM, 35 diagnosed with preeclampsia referred for fetal echocardiography, and 53 healthy controls without pregnancy-related complications with 106 overall participants. The study was conducted on patients attending the ultrasound unit of Benha University Hospital from March 2023 to March 2024. All participants were subjected to full history taking, clinical examination, laboratory investigations, and trans-abdominal ultrasound. All fetal biometric parameters and fetal heart rate were evaluated. Isovolumetric contraction time (ICT) + isovolumetric relaxation time (IRT)/ejection time (ET) was used to calculate the MPI (MPI = [ICT + IRT]/ET).