Fetal myocardial morphological and functional changes associated with well-controlled gestational diabetes

Abstract 

Objective

To make a global evaluation of the fetal myocardial changes in a well-controlled gestational diabetic population.

Study design

Twenty-four pregnant well-controlled diabetic patients were selected. Sixteen normal pregnancies were randomly collected as a control group. Measurements of morphological and functional myocardial parameters were performed. Data from the left ventricular outflow tract and peripheral Doppler data were obtained.

Result

The thickness of the interventricular septum was increased in diabetic pregnancies (p<0.001). Tricuspid E/A index was the only functional parameter showing a significant variation, with lower values in diabetic pregnancies. Doppler parameters from the left ventricular outflow tract and peripheral Doppler waveforms were similar between groups.

Conclusion

A tendency towards interventricular septum hypertrophy was observed even in well-controlled diabetic pregnancies. Mild hypertrophic cardiac changes were not associated with abnormal cardiac function or signs of left ventricular outflow obstruction, although minor changes in right ventricular diastolic function were recorded.

Keywords: Diabetes, Hypertrophic congenital cardiomyopathy, Doppler, Fetal echocardiography