Hypertrophic cardiomyopathy in a midtrimester fetus born to a diabetic mother

Leslie, Joanne; Shen, Susan; Strauss, Lotte

doi:10.1016/s0022-3476(82)80774-9

Cited by 19 publications

(6 citation statements)

References 12 publications

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“…While some studies have found that well-controlled glucose levels lead to better infant outcomes [5,6], many have found that even in women with glycosylated hemoglobin levels within an acceptable range, infants can still acquire clinically significant septal hypertrophy resulting in the need for medical treatment [4,7,8].…”

Section: Discussionmentioning

confidence: 99%

Utilization of extracorporeal membrane oxygenation in congenital hypertrophic cardiomyopathy caused by maternal diabetes

Groner

2013

Journal of Neonatal-Perinatal Medicine

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Extracorporeal membrane oxygenation (ECMO) is an advanced strategy utilized in many neonatal intensive care units for a specific list of indications. This case illustrates a rare but effective use of this therapy for a newborn infant with severe hypertrophic cardiomyopathy induced by maternal diabetes. Such infants who are unresponsive to conventional therapies may benefit from ECMO support, if it is used in conjunction with management strategies that optimize cardiac output.

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Section: Discussionmentioning

confidence: 99%

Utilization of extracorporeal membrane oxygenation in congenital hypertrophic cardiomyopathy caused by maternal diabetes

Groner

2013

Journal of Neonatal-Perinatal Medicine

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“…Case reports have indicated that cardiac failure secondary to cardiomyopathy may be the cause of death in so-called ''unexplained'' intrauterine death in fetuses of mothers with diabetes mellitus [13,15]. Recently, Prefumo and colleagues [16] reported a case of near-miss intrauterine death in which a macrosomic infant of a mother with diabetes mellitus with ultrasound features of hypertrophic cardiomyopathy deteriorated rapidly at the onset of uterine contractions in the late 3rd trimester.…”

Section: Discussionmentioning

confidence: 99%

Cardiomyopathy and Cardiomegaly in Stillborn Infants of Diabetic Mothers

et al. 2008

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To report the incidence of cardiomegaly in stillborn normally formed infants of mothers with diabetes mellitus. This is a retrospective study with institutional ethics approval. The presence of cardiomegaly was recorded in stillborn infants of diabetic mothers (N = 27) and compared with that recorded in stillborn large-for-gestational age (LGA > 90th percentile, n = 18) and stillborn appropriately grown (10th to 90th percentiles, n = 107) nondiabetic infants. Blinded to the clinical details, the histology slides were reviewed to measure cardiac wall thickness and to record the presence or absence of myocardial fiber disarray. Stillborn infants of mothers with diabetes mellitus, when compared with appropriately grown stillborn nondiabetic infants and when adjusted for birth weight, had heavier hearts, thicker ventricular free wall measurements, and lighter brains. While cardiomegaly was reported in 22% of stillborn LGA infants, comparison with stillborn appropriately grown infants revealed no difference in heart weights corrected for birth weight. Comparison of LGA nondiabetic infants with stillborn diabetes mellitus infants revealed greater actual heart weight/expected for birth weight (P < 0.05) and lighter brains (actual brain weight/expected for birth weight, P < 0.05) in the diabetes mellitus group. Cardiomegaly is a common finding in stillborn infants of mothers with diabetes mellitus and may contribute to the risk of fetal death in these pregnancies.

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“…The underlying mechanisms for our findings remain speculative. The left ventricular shortening fraction has been reported to range from normal2, 18, 19 to supranormal1, 20 in infants of diabetic mothers, while the right ventricular shortening fraction has also been found to be increased in fetuses of diabetic mothers in the late third trimester21. The increased peak velocities at the level of the left and right ventricular outflow tracts found in fetuses of diabetic mothers have also been attributed to increased ventricular contractility7.…”

Section: Discussionmentioning

confidence: 99%

Fetal myocardial performance in pregnancies complicated by gestational impaired glucose tolerance

Wong

Cheung

2007

Ultrasound in Obstet & Gyne

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Objective To determine fetal myocardial performance in pregnancies complicated by mild gestational impaired glucose tolerance (GIGT).Methods Ultrasound examinations were performed in 37 pregnant women with mild GIGT (36 did not require insulin) and in 44 controls at 18-24, 26-30 and 34-37 weeks of gestation. The thickness of the fetal ventricular walls and interventricular septum were measured by M-mode echocardiography. Using conventional Doppler echocardiography, the mitral and tricuspid early (E) and late (A) diastolic velocities and the ventricular myocardial performance index (MPI) were determined.Results The fetuses of women with GIGT had a greater abdominal circumference (P = 0.02), a larger amniotic fluid index (P = 0.03), and a tendency to be heavier (P = 0.058) at the third scan. There were no significant differences in myocardial thickness, mitral and tricuspid E and A velocities, and E/A ratios between study and control groups. The left and right ventricular MPIs, while similar between the two groups in the first and second scans, had decreased significantly by late gestation in the GIGT fetuses (P for trend = 0.018 and 0.014, respectively) and were significantly lower than those of the control group (P = 0.002 and 0.0008, respectively). Conclusions Fetuses of women with mild GIGT lack the ventricular hypertrophy and diastolic dysfunction that is common in fetuses of diabetic mothers, and they have a decreased MPI late in gestation.

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Hypertrophic cardiomyopathy in a midtrimester fetus born to a diabetic mother

Cited by 19 publications

References 12 publications

Utilization of extracorporeal membrane oxygenation in congenital hypertrophic cardiomyopathy caused by maternal diabetes

Utilization of extracorporeal membrane oxygenation in congenital hypertrophic cardiomyopathy caused by maternal diabetes

Cardiomyopathy and Cardiomegaly in Stillborn Infants of Diabetic Mothers

Fetal myocardial performance in pregnancies complicated by gestational impaired glucose tolerance

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