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 a… Show more
“…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.…”
Objective:The purpose of this study was to assess fetal cardiac function in normal fetuses (control group) compared to those who are exposed to gestational diabetes mellitus using different echocardiographic measurements, and to explore the application of left atrial shortening fraction in determination of fetal diastolic function with gestational diabetes mellitus.Methods:A total of 50 women with gestational diabetes and 50 women with a healthy pregnancy were included in the study. Fetal echocardiography was performed and structural as well as functional fetal cardiac parameters were measured. Data were compared between with or without fetal myocardial hypertrophy and the control group.Results:In the study group, out of 50 fetuses of gestational diabetic mothers, 18 had myocardial hypertrophy and 32 had normal septal thickness. Gestational age at time of examination did not differ significantly between the control and gestational diabetes group (p = 0.55). Mitral E/A ratio was lower in gestational diabetes group as compared to the control (p < 0.001). Isovolumetric relaxation and contraction times and myocardial performance index were greater in fetuses of gestational diabetic mothers (p < 0.001). In fetuses of gestational diabetic mothers with myocardial hypertrophy, left atrial shortening fraction was lower as compared to those without myocardial hypertrophy and those of the control group (p < 0.001).Conclusions:The results of this study suggest that fetuses of gestational diabetic mothers have altered cardiac function even in the absence of septal hypertrophy, and that left atrial shortening fraction can be used as a reliable alternate parameter in the assessment of fetal diastolic function.
“…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.…”
Objective:The purpose of this study was to assess fetal cardiac function in normal fetuses (control group) compared to those who are exposed to gestational diabetes mellitus using different echocardiographic measurements, and to explore the application of left atrial shortening fraction in determination of fetal diastolic function with gestational diabetes mellitus.Methods:A total of 50 women with gestational diabetes and 50 women with a healthy pregnancy were included in the study. Fetal echocardiography was performed and structural as well as functional fetal cardiac parameters were measured. Data were compared between with or without fetal myocardial hypertrophy and the control group.Results:In the study group, out of 50 fetuses of gestational diabetic mothers, 18 had myocardial hypertrophy and 32 had normal septal thickness. Gestational age at time of examination did not differ significantly between the control and gestational diabetes group (p = 0.55). Mitral E/A ratio was lower in gestational diabetes group as compared to the control (p < 0.001). Isovolumetric relaxation and contraction times and myocardial performance index were greater in fetuses of gestational diabetic mothers (p < 0.001). In fetuses of gestational diabetic mothers with myocardial hypertrophy, left atrial shortening fraction was lower as compared to those without myocardial hypertrophy and those of the control group (p < 0.001).Conclusions:The results of this study suggest that fetuses of gestational diabetic mothers have altered cardiac function even in the absence of septal hypertrophy, and that left atrial shortening fraction can be used as a reliable alternate parameter in the assessment of fetal diastolic function.
“…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.…”
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.
“…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.…”
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