Search

The fetal heart adapts dynamically to nutrient and oxygen needs from all fetal organs. These continuous changes make it difficult to define normal/abnormal cardiac function based only on the evaluation of a few cycles. Many signs of fetal cardiac dysfunction have been suggested; however, very few can stand as true manifestations of cardiac deterioration, and none has emerged as a single reliable marker of cardiac dysfunction. It is the combination of abnormal findings that provides a more accurate assessment of the status of the fetal heart function [ABSTRACT FROM AUTHOR]

Background: The myocardial performance index (MPI) can assist in the non-invasive diagnosis of coronary artery disease (CAD) in patients selected for further management. However, there is limited data on MPI in patients with Acute Coronary Syndrome (ACS), and its relationship with the severity of coronary atherosclerosis in this group remains unclear. This study aims to determine whether MPI can predict the angiographic severity of CAD and to evaluate its association with both systolic and diastolic dysfunction in patients with ACS. Methods: This Hospital Based Analytical Prospective cross-sectional study included a total 155 patients with acute coronary syndrome from December 2022 to May 2024 who underwent coronary angiography. Echocardiography evaluation of Myocardial Performance Index was done by using Pulse wave Doppler evaluation. Angiographic severity was done through Gensini scoring system. The ROC curves were constructed. It was deemed statistically significant when p< 0.001) between the Myocardial Performance Index (MPI) and the Gensini scoring system in the patients with Acute Coronary Syndrome. Results: In this study, patients were categorized based on low, mid, and high Syntax and Gensini scores. The MPI (Tei Index) exhibited statistically significant positive correlation with the Gensini scor e. Conclusion: Echocardiographic assessment of the Myocardial Performance Index (MPI) in patients with acute coronary syndrome can serve as a valuable surrogate marker for the detection of severity of coronary artery disease. It also has the potential to predict the complexity of coronary artery disease and guide the necessary interventions. [ABSTRACT FROM AUTHOR]

Introduction: This review aims to investigate the clinical implications of using the myocardial performance index (MPI), obtained through tissue Doppler imaging (TDI) and spectral Doppler, in assessing fetal cardiac function in growth-restricted fetuses. It explores the MPI's potential in predicting adverse perinatal outcomes and its utility when combined with conventional pulsed-wave Doppler assessments for enhanced fetal well-being evaluations. Material and Methods: A systematic search of PubMed and Google Scholar databases spanning from 2004 to 2023 was conducted to identify pertinent articles on the MPI's clinical application in managing growth-restricted fetuses. Inclusion criteria followed the Fetal Medicine Barcelona definition of fetal growth restriction (FGR) to mitigate study group heterogeneity. The research sources were PubMed and Google Scholar databases, and the review was conducted without any specific clinical or laboratory setting. Only articles meeting the inclusion criteria for FGR, as per the Fetal Medicine Barcelona definition, were considered. Six studies meeting these criteria were included in the review. The review analyzed the correlation between MPI values and conventional Doppler parameters, investigating the progression of myocardial function impairment and its association with the risk of fetal demise. The primary outcome measures included the relationship between MPI values, fetal well-being, and the potential for prenatal cardiac dysfunction in growth-restricted fetuses. Results: The findings indicate that as conventional Doppler parameters deteriorate, MPI values increase, suggesting progressive myocardial dysfunction. The MPI may cross the 95th percentile before abnormal flow in the ductus venosus and aortic isthmus, highlighting the potential for diastolic dysfunction preceding hypoxia in growth-restricted fetuses. Elevated MPI levels were observed in both growth-restricted and small-for-gestational-age (SGA) fetuses, indicating prenatal cardiac impairment. The strong association between an abnormal MPI and perinatal mortality has been shown for early FGR. Conclusions: MPI alterations appear to precede abnormal Doppler parameters in early- and late- onset FGR, potentially indicating diastolic dysfunction preceding hypoxia. Additionally, the MPI correlates with the risk of fetal demise. However, larger studies are needed to establish its sensitivity and specificity. Furthermore, the significance of prenatal cardiac impairment in some SGA fetuses raises questions about its potential impact on perinatal outcomes and cardiovascular programming. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate fetal left ventricular function (LVF) in pregnant women with obstetric antiphospholipid syndrome (OAPS) by Doppler ultrasound and developed a clinical nomogram to predict adverse perinatal outcomes. Methods: In this prospective observational study, 105 pregnant women were enrolled and divided into the OAPS cohort (n = 60) and the control cohort (n = 45). Fetal cardiac function parameters were collected and compared between two cohorts. Univariate and multivariate analysis was conducted to select the risk factors associated with adverse perinatal outcomes, and a clinical nomogram was developed based on these selected risk factors. The predictive performance of corresponding indicators for adverse perinatal outcomes was evaluated using receiver operating characteristic (ROC) curve analysis. Results: The OAPS cohort revealed an increase in the isovolumic relaxation time (IVRT) and myocardial performance index (MPI), a decrease in the ejection time (ET), middle cerebral artery pulsatility index (MCA-PI) and cerebroplacental ratio (CPR) compared to the control cohort. Through univariate and multivariate analysis, gravidity, CPR, and MPI were the risk factors associated with adverse perinatal outcomes. A model predicting adverse perinatal outcomes in OAPS pregnant women was constructed based on these three factors and visualized as a nomogram. The nomogram could accurately predict adverse perinatal outcomes with an area under the curve of 0.923 (95% CI: 0.858–0.982). This performance was better than evaluating individual factors such as MPI (0.825, 95% CI: 0.739–0.911) and CPR (0.816, 95% CI: 0.705–0.927) for efficacy. Conclusion: MPI can be used to assess fetal LVF and predict adverse perinatal outcomes. We developed a nomogram to predict adverse perinatal outcomes in OAPS women. This imaging-based evidence can provide timely clinical intervention, enabling personalized clinical decision-making. [ABSTRACT FROM AUTHOR]

Electrocardiography (ECG) can be used to evaluate myocardial perfusion by using Selvester QRS score. The myocardial performance index (MPI), which is easily assessed by echocardiography (ECHO), is a technique that assesses both systolic and diastolic function regardless of ventricular shape. Our aim was to compare the association between MPI and Selvester QRS score in ST segment elevation myocardial infarctus (STEMI) patients. Prospectively and sequentially, 101 patients with STEMI who came to our hospital b etween December 1, 2015, and September 31, 2017 were included in the research. The echocardiographies and ECGs performed between 24 -48 hours of admission. Based on MPI value we separated the population into two groups. We considered patients with MPI≥ 0.4 as group 1, and patients with MPI <0.4 as group 2. The mean age of the patients was 57,6 ± 11 years with 17% being female. The MPI and Selvester QRS score showed a positive correlation (coefficient: 0.501, p<0.001). A negative correlation was found between MPI and EF (coefficient: - 0.353, p = 0.001) and GFR (coefficient: -0.219, p = 0.028).In multivariable logistic regression analysis Selvester QRS score was an intependent predictor of MPI (%95 CI:0.599-0.981, p=0.035). In the ROC-curve analysis performed for MPI and Selvester QRS score, 69% sensitivity and 60% specificity were found for the Selvester QRS score cut -ff value of 3.5 (%95 CI:0.656-0.848, AUC:0.752, p <0.001). Our study's findings indicate that we may predict left ventricular MPI in STEMI patients receiving primary PCI by using the Selvester QRS score. [ABSTRACT FROM AUTHOR]

Aim: To investigate the role of the fetal modified myocardial performance index (Mod-MPI) and fetal cardiac output index measurement in predicting adverse perinatal outcomes amongpreterm dichorionic twins. Materials and Method: This prospective cohort study was conducted at the X Clinic andincluded 34 dichorionic twinfetuses bornearly preterm and 40 dichorionic twinfetusesborn late preterm.The early preterm group was divided into two according to whether they were admitted to theneonatal intensive care unit (NICU). The groups' cardiac function and Mod-MPI measurements were compared regardingtheir predictive ability for adverse perinatal outcomes. Results: The Mod-MPI values were similar between theearly and late pretermgroups (p=0.144). The leftventricular cardiac output Z-score was lower in the preterm group (p=0.014). The Mod-MPI and left ventricular outflow tractisovolumetric contraction and isovolumetric relaxation times were significantly higher among the newborns admitted to the NICU in the early preterm group (p=0.002, p=0.003, and p=0.001, respectively). Conclusion: Our study suggests that the Mod-MPI measurement can be used to predict adverse perinatal outcomes in dichorionic twin fetusesbornin the early preterm period. [ABSTRACT FROM AUTHOR]

Aim: Is there a change in the circulatory system in fetuses with renal disease in the prenatal period to make hemodynamic assessments. In addition, fetal cardiac functions in the same patients will be studied in detail using fetal echocardiography. Material and Method: Thirty-one fetuses with renal disease were included in the study; 4 with polycystic kidneys, 4 with bilateral hydronephrosis, 12 with unilateral hydronephrosis, and 28 with pelvicalyceal ectasia. In the control group, there were 30 fetuses of the same gestational week without renal disease. The circulatory system and hemodynamic status were examined in detail by fetal echocardiography in both groups. Results: High umbilical artery pulsatility index (PI) values were observed in 2 fetuses with bilateral hydronephrosis and 2 fetuses with unilateral hydronephrosis. The PI values of the middle cerebral artery were high in 2 fetuses with bilateral hydronephrosis and 2 cases with isolated pelvicalyceal ectasia. When the right and left myocardial performance index values of fetuses with renal disease were compared with normal fetuses, no significant results were observed, but the tricuspid valve pulse Doppler was abnormal in fetuses with fetal kidney disease. In addition, the right spherical index was higher in fetuses with renal disease than in the control group. Conclusion: Although there is no functional change, morphologic findings of right ventricular overload can be observed in fetuses with fetal renal disease. [ABSTRACT FROM AUTHOR]

Purpose: To elucidate the association between arterial and venous Doppler ultrasound parameters and the risk of secondary cesarean delivery for intrapartum fetal compromise (IFC) and neonatal acidosis in small-for-gestational-age (SGA) fetuses. Methods: This single-center, prospective, blinded, cohort study included singleton pregnancies with an estimated fetal weight (EFW) < 10th centile above 36 gestational weeks. Upon study inclusion, all women underwent Doppler ultrasound, including umbilical artery (UA) pulsatility index (PI), middle cerebral artery (MCA) PI, fetal aortic isthmus (AoI) PI, umbilical vein blood flow (UVBF), and modified myocardial performance index (mod-MPI). Primary outcome was defined as secondary cesarean section due to IFC. Results: In total, 87 SGA pregnancies were included, 16% of which required a cesarean section for IFC. Those fetuses revealed lower UVBF corrected for abdominal circumference (AC) (5.2 (4.5–6.3) vs 7.2 (5.5–8.3), p = 0.001). There was no difference when comparing AoI PI, UA PI, ACM PI, or mod-MPI. No association was found for neonatal acidosis. After multivariate logistic regression, UVBF/AC remained independently associated with cesarean section due to IFC (aOR 0.61 [0.37; 0.91], p = 0.03) and yielded an area under the curve (AUC) of 0.78 (95% CI, 0.67–0.89). A cut-off value set at the 50th centile of UVBF/AC reached a sensitivity of 86% and specificity of 58% for the occurrence of cesarean section due to IFC (OR 8.1; 95% CI, 1.7–37.8, p = 0.003). Conclusion: Low levels of umbilical vein blood flow (UVBF/AC) were associated with an increased risk among SGA fetuses to be delivered by cesarean section for IFC. [ABSTRACT FROM AUTHOR]

Our study aims to investigate the changes in cardiac functions, especially myocardial performance index (MPI), in patients who underwent parathyroidectomy for secondary hyperparathyroidism. Patients who underwent parathyroidectomy for secondary hyperparathyroidism between June 2010 and September 2021 were analyzed retrospectively. The patients were divided into two groups: those who underwent total parathyroidectomy (group 1) and those who underwent subtotal parathyroidectomy (group 2). The groups were compared according to the echocardiogram findings performed in the preoperative period and the postoperative sixth month. In addition, cardiac structure, and systolic and diastolic functions, especially myocardial performance index, were evaluated by echocardiography and Doppler imaging. Thirty-seven patients were examined; 16 (43.2%) underwent total parathyroidectomy, and 21 (56.8%) had subtotal parathyroidectomy performed. Group 1's mean left ventricular end-systolic diameter (LVES) decreased from 2.53 ± 0.57 to 2.35 ± 0.37 cm after parathyroidectomy. In Group 1, the postoperative value of LVES and end-systolic volume decreased significantly compared to the preoperative period (p = 0.042, p = 0.008, respectively). EF increased from 59.25 ± 0.05 to 67.81 ± 4.04. In Group 1, EF and EV postoperatively increased significantly compared to the preoperative period (p = 0.023, p = 0.021, respectively). The mean MPI decreased from 0.45 ± 0.07 to 0.39 ± 0.04 after parathyroidectomy in group 1. In group 2, it decreased from 0.46 ± 0.06 to 0.40 ± 0.04 (p < 0.001). The present study provides an improvement in myocardial functions after parathyroidectomy. While LVES, EF, ejection volume, end-systolic volume, and MPI improved in both groups, the MPI improvement was more evident in the total parathyroidectomy group. [ABSTRACT FROM AUTHOR]

Introduction: To assess changes in blood flow in the uterine, fetal cerebral, and umbilical arteries (UA) by Doppler ultrasound and alterations in the variability of fetal heart rate (FHR) as well as fetal cardiac performance by fetal echocardiography between the 7.00 a.m. and 7.00 p.m. periods in pregnancies ranging from 24 to 39 weeks. Methods: Fifty pregnant participants underwent a customized fetal examination on the same day during both study periods, including Doppler measurements of the umbilical artery pulsatility index (UA-PI), fetal middle cerebral artery-pulsatility index (MCA-PI), middle cerebral artery-peak systolic velocity (MCA-PSV), cerebroplacental ratio, uterine artery-pulsatility index (UtA-PI), FHR, and fetal movements as well as various Doppler parameters of the fetal heart such as left isovolumetric contraction and relaxation times, mitral E- and A-wave velocities, the E/A ratio, K-index, filling time, and the myocardial performance index. Results: During the PM period, there was a meaningful increase in the MCA-PSV compared with the AM period. Conversely, the resistance in the MCA, particularly the PI, was found to be lower than that in the AM period. In addition, the FHR measured in the PM period increased compared with that in the AM period. The maternal UtA-PI and fetal UA-PI examined in the AM and PM periods were comparable. In addition, when all cardiac parameters examined in the study periods were compared, no significant difference was observed. Conclusion: The findings reveal that Doppler parameters observed during the study periods may change during the day and that the fetal cardiac function parameters, previously not assessed together, may not change during the day. Subsequent investigations can validate these observations using serial measurements of Doppler parameters in healthy and complicated gravidas.

Introduction: To assess changes in blood flow in the uterine, fetal cerebral, and umbilical arteries (UA) by Doppler ultrasound and alterations in the variability of fetal heart rate (FHR) as well as fetal cardiac performance by fetal echocardiography between the 7.00 a.m. and 7.00 p.m. periods in pregnancies ranging from 24 to 39 weeks. Methods: Fifty pregnant participants underwent a customized fetal examination on the same day during both study periods, including Doppler measurements of the umbilical artery pulsatility index (UA-PI), fetal middle cerebral artery-pulsatility index (MCAPI), middle cerebral artery-peak systolic velocity (MCA-PSV), cerebroplacental ratio, uterine artery-pulsatility index (UtA-PI), FHR, and fetal movements as well as various Doppler parameters of the fetal heart such as left isovolumetric contraction and relaxation times, mitral E- and A-wave velocities, the E/A ratio, K-index, filling time, and the myocardial performance index. Results: During the PM period, there was a meaningful increase in the MCA-PSV compared with the AM period. Conversely, the resistance in the MCA, particularly the PI, was found to be lower than that in the AM period. In addition, the FHR measured in the PM period increased compared with that in the AM period. The maternal UtA-PI and fetal UA-PI examined in the AM and PM periods were comparable. In addition, when all cardiac parameters examined in the study periods were compared, no significant difference was observed. Conclusion: The findings reveal that Doppler parameters observed during the study periods may change during the day and that the fetal cardiac function parameters, previously not assessed together, may not change during the day. Subsequent investigations can validate these observations using serial measurements of Doppler parameters in healthy and complicated gravidas. [ABSTRACT FROM AUTHOR]

Objectives: To investigate whether fetal cardiac function is affected by underlying heart disease in pregnant women. Methods: A total of 100 pregnant women who were ≥34 gestational weeks were included in the study, 40 in the maternal heart disease (MHD) group diagnosed with heart disease and 60 in the control group. All cardiac diseases in pregnant women were diagnosed preconceptionally and categorized according to the New York Heart Association (NYHA) classification system. Fetal cardiac functions of study groups were evaluated by M‐mode, color tissue Doppler imaging (c‐TDI), and pulsed wave Doppler. Results: Tricuspid annular plane systolic excursion and myocardial performance index (MPI) values were significantly higher and isovolumetric relaxation time was prolonged in the MHD group. The MPI value was found higher in MHD group with NYHA Class II compared to those with NYHA Class I. No significant change in any of the fetal tricuspid annular peak velocity values measured by c‐TDI in the MHD group. There were no differences in fetal cardiac functions and perinatal outcomes between pregnant women with acquired and congenital heart diseases. Patients in NYHA Class II had lower birth weight, 1st and 5th minute APGAR scores, and higher neonatal intensive care unit admission rates. Conclusions: Underlying heart diseases in pregnant women can cause alterations in the systolic and diastolic function of the fetal heart. High fetal MPI values detected in cardiac patients may indicate that cardiac pathologies during pregnancy affect fetal cardiac globular myocardial function. Cardiac pathologies that progress with restricted physical activity may cause changes in fetal cardiac function and may be associated with adverse perinatal outcomes. [ABSTRACT FROM AUTHOR]

Purpose: To compare cardiac functions evaluated with echocardiography and tissue Doppler (TD) imaging between fetuses of pregnant women who were infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and were asymptomatic or had mild symptoms and fetuses of pregnant women who were not infected. Material and Methods: Early diastolic myocardial velocities (Em) and late myocardial velocities (Am) and Em/Am ratios were measured in the lateral annuli of tricuspid and mitral valves of fetuses of pregnant women with COVID-19 at more than 20 weeks of gestational age who had COVID-19 (n=45) and gestational age-matched healthy pregnant women's fetuses (n=43). The TDderived myocardial performance index (MPI) was also measured. Results: The gestational ages of the fetuses were found as 26.1 ± 3.3 and 26.6 ± 3.5 weeks, respectively. The mitral valve Em/Am ratio was 0.56±0.08 and 0.61±0.06 in the study group and the control group, respectively. The tricuspid valve Em/Am ratio was 0.58±0.11 and 0.63±0.10 in the study group and the control group, respectively. The TD-derived mitral valve MPI was 0.48±0.07 and 0.40±0.07 in the study group and the control group, respectively. Conclusion: Maternal COVID-19 affects fetal MPI and diastolic function. Fetal cardiac echocardiography should be performed during antenatal follow-up of low-risk, mildly symptomatic pregnant women infected with SARSCoV-2 without concomitant maternal comorbidity. [ABSTRACT FROM AUTHOR]

Copyright of MN Cardiology / MN Kardiyoloji is the property of Medical Network and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Myocardial dysfunction is an association of neonatal sepsis that might occur without underlying cardiac structural defect (CSD). Aims of the work: To study frequency of myocardial dysfunction (MD) in sepsis in full term neonates without CSD. Subjects and Methods: All the full term neonates with neonatal sepsis admitted to Neonatal Intensive Care Unit, Fayoum University between December 2019 and December 2020 without underlying CSD were included in the study. They underwent conventional echocardiography and tissue Doppler studies. Results: 103 neonates with neonatal sepsis were included in the study. Of them 30 patients (29.12%) were found to have myocardial dysfunction. Global myocardial dysfunction was encountered in 16 (53.3%), isolated right ventricle dysfunction in 8 (26.6%) cases, isolated left ventricle dysfunction among 6 (20%). The dysfunction was both systolic and diastolic in 2 (6.6%) cases, isolated systolic in 6 (20%), and isolated diastolic in 22 (73.3 %). No noted risk factors were associated with myocardial dysfunction as age (p=0.193), weight (p=0.100), sex (p=0.130) or type of bacterial infection (p=0.125). The outcome among those with myocardial dysfunction and those without was complete resolution in 13 (43.3%) and 43 (59%) patients (p=0.149), cardiogenic shock and death in 17 cases (56.7%) and 30 (41%) (p=0.149) respectively while no cases developed progressive cardiomyopathy. Conclusions: Full terms with neonatal sepsis can experience significant cardiovascular dysfunction that is either global or limited to right or left ventricle. The dysfunction might be systolic or diastolic or both. Myocardial dysfunction among neonates with sepsis might be self- limiting or culminates increasing the risk of mortality.

Background: Atrial switch operation, was introduced by Ake Senning in 1958 for patients with D-transposition of great arteries (D-TGA). The major disadvantage of the atrial switch procedure is right ventricle (RV) failure in up to 7% to 10% of patients per 10 years. Aims of the work: To detect subclinical RV failure in children with D-TGA after atrial switch repair using conventional and nonconventional echocardiography. Subjects and Methods: We studied 25 children with D-TGA who underwent atrial switch operation following in the Postoperative Cardiology Clinic at Cairo University Specialized Pediatric Hospital. They did not have symptoms of heart failure. They underwent conventional echocardiography, tissue Doppler and speckle tracking imaging including RV global longitudinal strain (RV GLS) to detect subclinical heart failure according to New York Heart Association (NYHA) classification. The results were compared to a matched control group. Results: Mean age ± standard deviation of the studied group was 6.8 ± 4.3 years while mean age at time of operation ranged 14.2 ± 12.7 months (p=0.001). Mean RV global longitudinal strain (GLS) of cases (-14.5± 1.5%) was significantly impaired compared to RV GLS of controls (-20.2 ± 1.4%) (p

Objective: To evaluate both short and mid‐term effects of maternal COVID‐19 on cardiac functions of fetuses and children. Methods: The present case‐control study was conducted on 36 pregnant women who had COVID‐19 infection in the second trimester of pregnancy and 30 pregnant women as healthy controls. Fetal, neonatal, and infant cardiac functions were compared between the groups. Assessment of fetal cardiac functions were performed in the last trimester of the pregnancy at least 6 weeks after the recovery of infection. The first postnatal echo was performed within the first 2 weeks and the follow‐up (second) echo was performed in the 6–8 weeks of life. Results: The demographic data were similar between groups. Interventricular septum and left ventricular posterior wall end‐diastolic dimensions were significantly higher in the study group in both fetal, neonatal, and infant periods. Impaired diastolic functions of right and left ventricles were detected and myocardial performance indexes with tissue doppler imaging of both lateral walls and septum were significantly higher than controls at all periods. Conclusion: Maternal COVID‐19 seems to have a global impact on the cardiac functions of babies in the short and mid‐term periods after maternal recovery. [ABSTRACT FROM AUTHOR]

Objective: To assess the impact of overweight and obesity in the second and third trimesters of pregnancy on fetal cardiac function parameters., Methods: We performed a prospective cohort study of 374 singleton pregnant women between 20w0d and 36w6d divided into three groups: 154 controls (body mass index - BMI < 25 kg/m 2 ), 140 overweight (BMI 25-30 kg/m 2 ) and 80 obese (BMI ≥ 30 kg/m 2 ). Fetal left ventricular (LV) modified myocardial performance index (Mod-MPI) was calculated according to the following formula: (isovolumetric contraction time + isovolumetric relaxation time)/ejection time. Spectral tissue Doppler was used to determine LV and right ventricular (RV) myocardial performance index (MPI'), peak myocardial velocity during systole (S'), early diastole (E'), and late diastole (A')., Results: We found significant differences between the groups in maternal age (p < 0.001), maternal weight (p < 0.001), BMI (p < 0.001), number of pregnancies (p < 0.001), parity (p < 0.001), gestational age (p = 0.013), and estimated fetal weight (p = 0.003). Overweight pregnant women had higher LV Mod-MPI (0.046 versus 0.044 seconds, p = 0.009) and LV MPI' (0.50 versus 0.47 seconds, p < 0.001) than the control group. Obese pregnant women had higher RV E' than control (6.82 versus 6.33 cm/sec, p = 0.008) and overweight (6.82 versus 6.46 cm/sec, p = 0.047) groups. There were no differences in 5-min APGAR score < 7, neonatal intensive care unit admission, hypoglycemia and hyperglobulinemia between the groups., Conclusions: We observed fetal myocardial dysfunction in overweight and obese pregnant women with higher LV Mod-MPI, LV MPI' and RV E' compared to fetuses from normal weight pregnant women.