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

Abstract

BACKGROUND To assess the interventricular septum (IVS) volume of fetuses from pre-gestational diabetes mellitus (DM) pregnant women by 3-dimensional ultrasound using spatiotemporal image correlation (STIC) and virtual organ computer-aided analysis (VOCAL) methods. METHODS This was a prospective cross-sectional study of 45 fetuses from pre-gestational DM and 45 fetuses from healthy pregnant women (controls). Only singleton pregnancies between 20 and 34 + 6 weeks of gestation were included. The fetal IVS volumes were obtained off-line using STIC and VOCAL methods. To analyze differences among variables, the Student’s t-test and Mann-Whitney U test were used. The correlation among continuous variables was determine using Spearman’s correlation test (r). RESULTS The median of fetal IVS volume was significantly higher in pre-gestational DM than in healthy pregnant women (0.3 cm 3 vs. 0.2 cm 3 , p = 0.032). A strong positive correlation was observed between fetal IVS volume and gestational age at the time of ultrasound examination (r = 0.75, R 2 = 0.48, p < 0.0001) and between fetal IVS volume and estimated fetal weight (r = 0.63, R 2 = 0.37, p < 0.0001). No significant correlation was noted between fetal IVS volume and glycated hemoglobin levels (r = −0.16, R 2 = 0.01, p = 0.540) in the pre-gestational DM pregnant women. CONCLUSIONS Significant differences were observed in fetal IVS volumes between pre-gestational and healthy mothers, with higher values in the fetuses of pre-gestational DM pregnant women.

Comparison of fetal and neonatal cardiac morphology between the infants of mothers with well-controlled gestational diabetes mellitus and normal controls

“…5 Several studies have shown that GDM is significantly associated with both morphological and functional changes in the fetal heart. [6][7][8][9][10] Though the true mechanism is still unclear, it has been demonstrated that fetal cardiac changes are partly caused by fetal hyperglycemia and hyperinsulinemia, which triggers fat and protein synthesis in myocardial cells. 11,12 Fetal myocardial changes may be observed in even cases with wellcontrolled GDM.…”

Multi-modality Echocardiography for Cardiac Assessment in Fetuses of Pregnant Women With Diabetes Mellitus

“… 19) 20) Bravo-Valenzuela et al 21) reported significantly smaller fetal left atrial volume in fetuses from pregestational DM women than healthy mothers. Melo Júnior et al 20) reported no significant difference in mean fetal myocardial volume between normal pregnant women and those with pregestational diabetes, whereas Edward Bravo-Valenzuela et al 22) showed the significantly higher fetal IVS volumes by 3D ultrasound with STIC with VOCAL methods in pregestational DM mothers than healthy mothers.…”