Assessment of fetal right ventricular myocardial performance index changes following intrauterine transfusion

J Matern Fetal Neonatal Med. 2021 Sep;34(18):3046-3049. doi: 10.1080/14767058.2019.1677595. Epub 2019 Oct 13.

Abstract

Introduction: Severe fetal anemia may cause cardiac ischemia, reduced contractility, and dysfunction. The purpose of our study is to evaluate right ventricular myocardial performance index (MPI) before and after intrauterine transfusion (IUT) in patients who underwent this procedure because of fetal anemia due to Rh-D alloimmunization.

Materials and methods: This prospective cohort study was conducted between January 2018 and June 2019 at Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey. The pregnant women who were applied IUT because of fetal anemia due to Rh-D alloimmunization in our perinatology clinic were included in the study. Fetal right ventricular MPI before and 24 h after IUT were evaluated.

Results: A total of 28 IUTs were performed in 17 pregnant women during the study period. The isovolumetric contraction time (ICT) and isovolumetric relaxation time (IRT) values measured before IUT, were found to be significantly longer compared to the ICT and IRT values measured after IUT. The MPI values measured after transfusion was found to be higher than before transfusion.

Conclusions: The fetal right ventricular MPI increases 24 h after IUT. This increase in the right ventricular MPI might be used as a marker for predicting adverse fetal outcomes following IUT.

Keywords: Fetal anemia; Rh-D alloimmunization; intrauterine transfusion; myocardial performance index; right ventricle.

MeSH terms

  • Blood Transfusion, Intrauterine
  • Female
  • Fetal Diseases* / diagnostic imaging
  • Humans
  • Pregnancy
  • Prospective Studies
  • Rh Isoimmunization* / complications
  • Turkey