PO-0493 Cardiac Involvement In Newborn Of Diabetic Mother

Abstract

Objectives To present the main aspects of cardiac involvement in newborn of diabetic mothers (IDMs). Methods: Patients:89 IDMs newborns investigated in the first week of life and 53 of them re evaluated at 6–12 month, by clinical exam, ECG,cardiothoracic radiography (Rx. CT), chocardiography (Echo). Fetal echo:in 38 cases after 28 weeks of gestation. Results Fetal Echo:cardiomegaly and myocardial hypertrophy of LV(11 cases), confirmed by postnatal Echo. Clinical exam:macrosomia (40%), systolic murmur (32), 3 cases with signs of heart failure, the other being asymptomatic or presenting signs for other pathology. ECG: LV hypertrophy (14) and disturbed ventricular repolarization (30). Rx. CT: cardiomegaly (12). Echo: non obstructive hypertrophic cardiomyopathy (HCMP) with asymmetric IVS hypertrophy (42%), arterial pulmonary hypertension (6), LV diastolic dysfunction,normal systolic function (52%), congenital cardiac anomalies (16%). LV myocardial hypertrophy was not significantly correlated with the type of mother’s diabetes, before pregnancy or gestational, but rather to an inadequate control of disease. Control at 6–12 months revealed: normal morphological cardiac aspect (42) or significant reduction of HCMP (11), all normal diastolic and systolic LV function. Conclusions Newborn of diabetic mother presents a high incidence for cardiac involvement: cardiac congenital malformations (16%) or acquired cardiac pathology: hypertrophic cardiomyopathy (42%) and disturbances of diastolic function of LV (54%), symptomatic or asymptomatic. Fetal echo provides useful data for diabetic pregnant women. Early cardiologic screening for all of these newborns with or without of cardiac suffering symptoms, especially by echo that is the most sensitive, noninvasive method for initial diagnosis as well as for follow up.

Cardiovascular anomalies in infants born to diabetic mothers: A study at a Tertiary Care Hospital.

“…16 Dimitriu et al shared that cardiac abnormalities were noted in 23% of the IDMs, without being affected by pulmonary hypertension and HCM. 17 Schafer et al mentioned in their study that the occurrence of cardiovascular anomalies among all other anomalies was 37.6%. 18 The literature states no significant differences in the occurrence of cardiac malformations in infants (p=0.29) with any type of maternal diabetes.…”

Prevalence of Hypertrophic Cardiomyopathy in Fetuses of Mothers with Gestational Diabetes before Initiating Treatment

“…5 The incidence of HCM, especially interventricular septal hypertrophy (IVSH), varies between 10% and 71%. [6][7][8] An increase in the ventricular wall thickness may also be involved in the cardiac changes observed in fetuses of mothers with GDM, but septal hypertrophy is more studied because of the higher number of insulin receptors in the septum of the heart. 9 Prenatal HCM is diagnosed through intrauterine two-dimensional echocardiography, and, based on the results, physicians may provide appropriate postnatal care and follow-up for cardiac hypertrophy progression during the gestational period.…”