Prevalence of Hypertrophic Cardiomyopathy in Fetuses of Mothers with Gestational Diabetes before Initiating Treatment

Abstract

Objective To evaluate the prevalence of hypertrophic cardiomyopathy (HCM) in fetuses of pregnant women with gestational diabetes mellitus (GDM) in the beginning of the treatment. Methods A cross-sectional study was performed between July 1, 2013, and December 20, 2013, in a public maternity clinic in southern Brazil. The subjects were 63 fetuses of mothers with gestational diabetes, with a single pregnancy and no other associated pathologies. We diagnosed HCM through a fetal echocardiography before treatment and evaluated the maternal and fetal characteristics. Results The average age of the pregnant women was 32.32 (AE6.2) years, and the average gestational age at the time of the evaluation was 30.59 (AE2.27) weeks. The interventricular septum thickness showed a standard deviation of more than two in 50.8% of the fetuses (95% confidence interval [95%CI]: 38.1-63.5%). The left ventricular wall thickness showed a standard deviation of more than 2 in 13 (20.6%) fetuses (95%CI: 11.1-30.2%). The HCM was confirmed in 54% of the fetuses (95%CI: 41.3-65.1%). The fetal abdominal circumference was normal in 46 (73%) fetuses, and 50% of these fetuses had HCM. Conclusion The prevalence of hypertrophic cardiomyopathy in fetuses of pregnant women with GDM before treatment was of 54% (95%CI: 41.3-65.1%).

Evaluation of cardiac function in fetuses of mothers with gestational diabetes

“…15 Myocardial hypertrophy, as a result of fetal hyperglycemia and hyperinsulinism, is a frequent finding in the fetuses of diabetic mothers, which may lead to increased ventricular stiffness thereby affecting diastolic ventricular filling as well as systolic cardiac function. [16][17][18] It is well known that impairment of ventricular function may cause diastolic dysfunction first and subsequently lead to systolic dysfunction in children with heart diseases. However, data in the literature, evaluating specific systolic and diastolic parameters in fetuses, are varied due to variation in methods used by researchers to evaluate heart function.…”

Fetal Interventricular Septum Volume Evaluated by Three-Dimensional Ultrasound Using Spatiotemporal Image Correlation and Virtual Organ Computer-Aided Analysis in Fetuses From Pre-Gestational Diabetes Mellitus Pregnant Women

“…The prevalence of fetal hypertrophic myocardiopathy, conotruncal anomalies, ventricular septal defects, and other cardiac malformations is increased in mothers with DM and is associated with higher rates of perinatal morbidity and mortality. 2) 14) 15) The hypertrophy of IVS is the most common structural cardiac anomaly in fetuses from mothers with DM, and with a deleterious risk on the fetal heart function. In this scenario, several studies have been published including ultrasound/echocardiographic fetal cardiac functional parameters by M-mode, Doppler, 2D and 3D ultrasound in the fetuses of mothers with DM.…”

Local Preserving Class Separation Framework to Identify Gestational Diabetes Mellitus Mother Using Ultrasound Fetal Cardiac Image

“…There have been a few works recently that examined the thickness of the interventricular septum (IVS), which separates the left and right ventricles, in FMH. Carolina et al [24] evaluated the prevalence of FMH in the fetuses of pregnant women with GDM, and they found that 54% of 63 fetuses tested positive for FMH on fetal echocardiography. Mohammed et al [25] employed five-dimensional (5D) fetal echocardiography for the diagnosis of prenatal fetal hypertrophic cardiomyopathy on three separate groups: healthy members, controlled diabetic mothers, and uncontrolled diabetic mothers.…”