Assessment of Fetal Cardiac Function in Women with Chronic Hypertension
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Abstract
Objectives: The primary objective was to compare the fetal myocardial performance index (MPI) among pregnant women with chronic hypertension and women with normal blood pressure. The secondary objectives were to evaluate whether the fetal MPI can predict adverse perinatal outcomes and to assess uterine, middle cerebral, and umbilical arteries in pregnant women with chronic hypertension and normal blood pressure.
Materials and Methods: A cross-sectional study enrolled singleton pregnancies with a gestational age of 28-32 weeks in the antenatal clinic at King Chulalongkorn Memorial Hospital between April 2020 - April 2021. This study divided pregnant women into two groups, those with normal blood pressure and those with chronic hypertension. The fetuses were evaluated for growth, amniotic fluid volume, and fetal cardiac function.
Results: The median of modified MPI was not different between chronic hypertension and control groups (0.49 vs 0.47, p = 0.691, adjusted p = 0.299). The median of the Doppler studies showed no differences between groups in the left uterine artery pulsatility index (PI) (0.78 vs 0.76, p = 0.085, adjusted p = 0.902), right uterine artery PI (0.83 vs 0.75, p = 0.159, adjusted p = 0.442), umbilical artery PI (0.94 vs 0.93, p = 0.982, adjusted p = 0.060), middle cerebral artery PI (1.86 vs 1.80, p = 0.311, adjusted p = 0.05). The chronic hypertension group developed more maternal adverse outcomes, such as gestational age at birth (36.8 ± 2.19 vs 38.2 ± 1.31, p < 0.001, adjusted p < 0.001). Women in the chronic hypertension group also experienced more neonatal adverse outcomes, including length of hospital stays (4.0 vs 3.0, p < 0.001, adjusted p = 0.001). No differences were found in other neonatal adverse outcomes.
Conclusion: There was no difference in the median of the MPI between pregnant women with normal blood pressure and women with chronic hypertension. The Doppler studies of the umbilical artery, middle cerebral artery, and uterine artery were not different between the chronic hypertension group and the control group. The modified MPI may not be predictive of perinatal outcomes.
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