Predictive Value of Fetal Modified Myocardial Performance Index and Cerebroplacental-Uterine Ratio for Adverse Perinatal Outcomes in Late Onset Preeclampsia and Diabetes Mellitus

September 6, 2026 updated by: Alaa Gamal Abd El-Naser, Assiut University

Predictive Value of The Modified Myocardial Performance Index and The Cerebroplacental-Uterine Ratio for Adverse Perinatal Outcomes in Late Onset Preeclampsia and Diabetes Mellitus: Prospective Cohort Study

High-Risk Pregnancies complicated by gestational diabetes mellitus (GDM) and preeclampsia (PE) represent a significant global health challenge, affecting approximately 15-20% of all pregnancies. These conditions are major contributors to adverse perinatal outcomes, including respiratory distress, neonatal hypoglycemia, and NICU admission. Beyond these, growing evidence suggests that the fetal heart undergoes early structural and functional adaptations to the altered intrauterine environment .

Current strategies for fetal surveillance mainly rely on conventional Doppler indices including umbilical artery, middle cerebral artery, and cerebroplacental ratio (CPR).Recently, interest has shifted toward combining cardiac functional assessment with placental Doppler parameters to improve prediction of adverse neonatal outcomes .

The Modified Myocardial Performance Index has emerged as a sensitive Doppler-derived parameter for assessment of global fetal cardiac function through evaluation of systolic and diastolic time intervals. Several studies demonstrated elevated Mod-MPI values in fetuses affected by placental insufficiency and maternal metabolic disorders reflecting early fetal cardiac dysfunction .

More recently, the cerebroplacental-uterine ratio (CPUR) has been introduced as a novel Doppler index that incorporates both fetal and maternal circulatory parameters.

Therefore, further research is needed to evaluate advanced Doppler indices , particularly the cerebroplacental-uterine ratio (CPUR) and Mod-MPI in high risk pregnancy complicated by Diabetes mellitus and preeclampsia .This may enhance early detection of fetal compromise and improve prediction of neonatal morbidity. The rationale of the present study Is based on the need for a reliable, reproducible, and clinically applicable fetal cardiac assessment tool that can complement conventional Doppler surveillance and optimize perinatal management in high-risk pregnancies.

Study Overview

Status

Not yet recruiting

Conditions

Pregnancy Diabetic

Study Type

Observational

Enrollment (Estimated)

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

Child
Adult
Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Probability Sample

Study Population

Participants will be divided into three primary arms:

Diabetes Mellitus (DM): further stratified into gestational diabetes mellitus (GDM) and pregestational diabetes mellitus.
Preeclampsia (PET): late onset preeclampsia will included.
Healthy Controls: Singleton pregnancies with no maternal or fetal complications.

Description

Inclusion Criteria:

1.pregnancy complicated diabetes mellitus (DM) group 2.Preeclampsia (PET) group. 3.Healthy control group.

Exclusion Criteria:

1. Multiple pregnancy 3.Chronic hypertension 4.Congenital fetal anomalies 5.Fetal growth restriction 6.Maternal cardiac or renal disease 7.Poor visualization during ultrasound examination

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Number of groups / cohorts

Cohorts and Interventions

Group / Cohort
preeclampsia
Healthy pregnancies
Pregnancy Diabetic

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
• the predictive value of Fetal MOD-MPI and CPUR in pregnancies complicated by diabetes mellitus and preeclampsia to predict adverse perinatal outcomes. Time Frame: >34wks to delivery	Adverse events include Neonatal death Apgar score <7 at 5 min Fetal distress	>34wks to delivery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Assiut University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

September 1, 2026

Primary Completion (Estimated)

September 30, 2028

Study Completion (Estimated)

September 30, 2028

Study Registration Dates

First Submitted

August 16, 2026

First Submitted That Met QC Criteria

September 6, 2026

First Posted (Actual)

September 9, 2026

Study Record Updates

Last Update Posted (Actual)