Abstract
Objectives To present the main aspects of cardiac involvement in newborn of diabetic mothers (IDMs). Methods: Patients:89 IDMs newborns investigated in the first week of life and 53 of them re evaluated at 6–12 month, by clinical exam, ECG,cardiothoracic radiography (Rx. CT), chocardiography (Echo). Fetal echo:in 38 cases after 28 weeks of gestation. Results Fetal Echo:cardiomegaly and myocardial hypertrophy of LV(11 cases), confirmed by postnatal Echo. Clinical exam:macrosomia (40%), systolic murmur (32), 3 cases with signs of heart failure, the other being asymptomatic or presenting signs for other pathology. ECG: LV hypertrophy (14) and disturbed ventricular repolarization (30). Rx. CT: cardiomegaly (12). Echo: non obstructive hypertrophic cardiomyopathy (HCMP) with asymmetric IVS hypertrophy (42%), arterial pulmonary hypertension (6), LV diastolic dysfunction,normal systolic function (52%), congenital cardiac anomalies (16%). LV myocardial hypertrophy was not significantly correlated with the type of mother’s diabetes, before pregnancy or gestational, but rather to an inadequate control of disease. Control at 6–12 months revealed: normal morphological cardiac aspect (42) or significant reduction of HCMP (11), all normal diastolic and systolic LV function. Conclusions Newborn of diabetic mother presents a high incidence for cardiac involvement: cardiac congenital malformations (16%) or acquired cardiac pathology: hypertrophic cardiomyopathy (42%) and disturbances of diastolic function of LV (54%), symptomatic or asymptomatic. Fetal echo provides useful data for diabetic pregnant women. Early cardiologic screening for all of these newborns with or without of cardiac suffering symptoms, especially by echo that is the most sensitive, noninvasive method for initial diagnosis as well as for follow up.
Published Version
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