Fetal cardiac functional performance and development of diabetic gestations

Abstract

Objective of research: To reveal and asses probable change in fetal cardiac physiological function of pregestational diabetic gestations. Research design: We performed a prospective research study of 31 gestations between 22 weeks’ gestational age and full term, and who had pregestational diabetes. All diabetic women recruited in the research performed had glycosylated hemoglobin lower than 6.5%. All gestations involved in the research performed had an early sonographic confirmation of fetal gestational age. Doppler study of blood flow via the fetal mitral and tricuspid valves were performed every 4 weeks using a pulsed wave sonographic Doppler machine with a 3.5- or 5-MHz ultrasound transducer. The subsequent parameters were analysed and calculated automatically from the revealed flow velocity waveforms: the peak velocity during the rapid ventricular filling phase (E wave) and during the atrial systole phase (A wave), and the ratio between these obtained velocities (E/A ratio); and the velocity time fundamental of the fetal atrioventricular blood flow (correlated with volume flow). A comparative statistical analysis between the Doppler parameters revealed from fetal examination of diabetic gestations and of normal gestations was performed by using the Mann-Whitney test. Results: Each gestation recruited for the study performed around four to five fetal echocardiographic Sonographic assessments at 22, 26, 30, 34, and 38 weeks’ gestation. The E/A ratio of the mitral and tricuspid valves did not Rise in fetuses of diabetic women during the third trimester and was observed to be statistically significantly higher manner in fetuses of nondiabetic gestations in comparison with fetuses of diabetic gestations at 34 and 38 gestational weeks. Calculated velocity time basic of the mitral and tricuspid valves when multiplied by fetal heart rate was greater, but not statistically significant, in fetuses of nondiabetic gestations when put in comparison with diabetic gestations fetuses at 34 and 38 weeks’ gestational weeks. The E-wave of both the mitral and tricuspid valves rised in both study categories all the way through pregnancy. The A-wave of the mitral and tricuspid valves rised only in diabetic gestation fetuses all over the final gestational trimester and was statistically significant in a greater manner at 34 and 38 gestational weeks compared with fetuses of nondiabetic women. Conclusion: variability in fetal atrioventricular blood flow forms between fetuses of diabetic gestations and normal gestations does not essentially cause variability in fetal functional cardiac compliance.