Fetal cardiac Doppler changes in gestational diabetic pregnancies and its relationship with perinatal outcomes

Abstract

Aim: To examine the structural and functional changes of the fetal heart in gestational diabetes mellitus (GDM) and to evaluate the power of fetal cardiac Doppler parameters in predicting adverse perinatal outcomes in this group of pregnancy. Methods: Within the study's scope, 36 cases in the A1 GDM group, 33 cases in the A2 GDM group, and 124 cases in the control group were evaluated. The relationship between structural and functional fetal cardiac parameters and perinatal outcomes was evaluated via fetal echocardiography. Results: Fetal left ventricular myocardial performance index (MPI) values were found to be statistically significantly higher when compared between the A1 GDM and A2 GDM groups and the control group (p = 0.000 and p = 0.000, respectively), while the E/A ratio was found to be significantly lower (p = 0.000 and p = 0.000, respectively). It was determined that the maternal blood HbA1c level showed a significant negative correlation with the fetal cardiac E/A ratio and a significant positive correlation with isovolumetric relaxation time and MPI (p = 0.000, p = 0.000, and p = 0.000, respectively). Adverse perinatal outcome rate was higher in the diabetic group (46.4%-22.6%). When the cases with GDM were examined in terms of perinatal outcomes, it was observed that there was a significant difference in HbA1c levels, E/A ratio, and MPI values between the cases in the group with adverse perinatal outcomes and the group with normal results (p = 0.001, p = 0.000, and p = 0.000, respectively). Conclusions: The strong relationship between abnormal cardiac function and adverse perinatal outcomes suggest that cardiac Doppler may be a valuable tool for fetal monitoring and management for the GDM patient group.

Early-pregnancy maternal heart rate is related to gestational diabetes mellitus (GDM)

“…The result furtherly proved the potentially significant effect hyperglycemia has on the vascular wall, even over a short duration in pregnancy. The hyperglycemia state not only affect maternal hemodynamics during pregnancy, but also affect the developing cardiovascular system and autonomic nervous system in the fetus [21,22]. The predictive value of maternal RHR we found in the current study is similar with the finding of Sirico et al [8], whose research found that early pregnancy fetal heart rate could be an independently correlated to the risk of developing GDM and a threshold of 162 bpm has high detection rate for GDM.…”

The effect of gestational diabetes mellitus on fetal right heart growth in late‐term pregnancy: A prospective study

“…Several limitations of our study should be mentioned. Because our study aimed to elucidate the association between GDM and fetal cardiac development, we did not perform a subgroup analysis according to the treatment style of GDM subjects, whereas studies have shown that glycemic control levels of GDM patients is associated with fetal myocardial development 29,30 . In addition, our study observed fetal heart development during late pregnancy; long term evaluation is still needed to demonstrate the potential effect of GDM on offspring's cardio development.…”

Fetal cardiac left ventricle functional changes in pregnancies with maternal hypothyroidism

“…After these advances in technique, Mod-MPI has been accepted as a reliable and useful marker to evaluate fetal cardiac function in cases of many maternal morbidities and pregnancy complications, especially preeclampsia, diabetes, and fetal growth restriction. [10][11][12] The present study primarily aimed to evaluate fetal cardiac function in cases with overt and subclinical hypothyroidism. Our second aim was to reveal the effects of levothyroxine (LT4) treatment and Anti-thyroid peroxidase (Anti-TPO) antibody status on fetal cardiac functions in the subclinical hypothyroid group.…”

“…made the reproducibility of the measurements possible using valve signals. After these advances in technique, Mod‐MPI has been accepted as a reliable and useful marker to evaluate fetal cardiac function in cases of many maternal morbidities and pregnancy complications, especially preeclampsia, diabetes, and fetal growth restriction 10–12 …”