Abstract
BackgroundDiabetes mellitus (DM) is the commonest medical disorder faced during pregnancy and it includes type I, type II, and gestational diabetes. It may predispose to various complications including fetus malformation, macrosomia, spontaneous abortion, stillbirth, neonatal death, and intrauterine growth retardation. Hypertrophic cardiomyopathy (HCM) is one of the common anomalies depicted with diabetes. Fetal cardiac function analysis might provide important information on the hemodynamic status and cardiac adaptation to different perinatal complications.ResultsThe mean septal thickness in the diabetic group was 0.7163 ± 0.1746 cm and 0.4989 ± 0.08068 cm in the control group. The mean myocardial thickness of the right ventricular free wall in the diabetic group was 0.6532 ± 0.13792 cm and 0.4874 ± 0.07482 cm in the control group. The mean myocardial thickness of the left ventricular free wall in the diabetic group was 0.6437 ± 0.13421 cm and 0.4737 ± 0.07573 cm in the control group. The mean value of myocardial performance index (Tie Index) in the diabetic group was 0.6232 ± 0.15606 and 0.4626 ± 0.04357 in the control group.ConclusionFrom our study, we can conclude that prenatal complete echocardiographic study should be mandatory in fetuses of diabetic mothers due to high risk of congenital heart defects and onset of hypertrophic cardiomyopathy with fetal cardiac function impairment in the third trimester.Early diagnosis of congenital heart defects as well as evidence of hypertrophic cardiomyopathy and fetal cardiac function impairment that occurs in fetuses of maternal diabetes will definitely guide prompt postnatal therapy and care for those neonates.
Highlights
Diabetes mellitus (DM) is the commonest medical disorder faced during pregnancy and it includes type I, type II, and gestational diabetes
We found the following: We found that the mean interventricular septal thickness (IVST) in the diabetics patients group was 0.7163 ± 0.1746 cm and 0.4989 ± 0.08068 cm in the control group (Fig. 1)
We found that the mean myocardial thickness of the right ventricular free wall (RVWT) in the diabetic group was 0.6532 ± 0.13792 cm and 0.4874 ± 0.07482 cm in the control group (Fig. 2)
Summary
Diabetes mellitus (DM) is the commonest medical disorder faced during pregnancy and it includes type I, type II, and gestational diabetes. Hypertrophic cardiomyopathy (HCM) is one of the common anomalies depicted with diabetes. Hypertrophic cardiomyopathy (HCM) is one of the common congenital anomalies depicted with diabetes mellitus (DM), requires high index of suspicion as the specific management may vary; for example, inotropic agents or digoxin which may be used in heart failure associated with structural heart defects are contraindicated if hypertrophic cardiomyopathy is present [3]. In diabetic mothers’ infants, it is suggested that HCM arise from the effects of excess in insulin level. It is suggested that increase in fetal insulin level can trigger hyperplasia and hypertrophy of myocardial cells. This hypertrophy mainly affects the interventricular septum and can occur despite tight glycemic control [6]
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