Assessment of Cardiac Function in Fetuses of Gestational Diabetic Mothers During the Second Trimester
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Fetuses of diabetic mothers may have structural or functional cardiac abnormalities which increase morbidity and mortality. Isolated functional abnormalities have been identified in the third trimester. The aim of the present study was to assess fetal cardiac function (systolic, diastolic, and global myocardial performance) in the second trimester in mothers with gestational diabetes, and also to relate cardiac function with glycemic control. Mothers with gestational diabetes mellitus referred for fetal cardiac evaluation in the second trimester (between 19 and 24 weeks) from March 2015 to February 2016 were enrolled as case subjects in this study. Non-diabetic mothers who had a fetal echocardiogram done between 19 and 24 weeks for other indications were enrolled as controls. Functional cardiac variables showed a statistically significant difference in isovolumetric relaxation and contraction times and the myocardial performance index and mitral E/A ratios in the gestational diabetic group (p = 0.003). Mitral annular plane systolic excursion was significantly less in the diabetic group (p = 0.01). The only functional cardiac variable found abnormal in mothers with poor glycemic control was the prolonged isovolumetric relaxation time. Functional cardiac abnormalities can be detected in the second trimester in fetuses of gestational diabetic mothers and timely intervention can improve postnatal outcomes.
KeywordsGestational diabetes mellitus Functional cardiac abnormalities Fetal diastolic dysfunction Fetal echocardiography
The authors acknowledge the statistical assistance provided by Mr Iqbal Azam and the echocardiographic technical assistance by Ms Salima Ashiq Ali and Urooj Fatima.
Compliance with Ethical Standards
Conflict of interest
The authors declare no conflict of interest. The corresponding (first author) has done the study with the technical help of echocardiography staff and would shoulder the responsibility of the overall integrity of the work. The last 3 authors have collectively contributed to the conception, design, collection of data, and critical revision.
Informed consent was obtained from all individual participants included in the study.
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