Fetal cardiac performance in uncomplicated and well-controlled maternal type I diabetes.
OBJECTIVE
To study the impact of well-controlled, uncomplicated maternal diabetes on fetal cardiac development and performance.


METHODS
The following variables were studied in 45 fetuses of type I diabetic women by means of mid- and late-trimester echocardiography: interventricular septal thickness; aortic and pulmonary valve diameters; peak and time-to-peak flow velocity of the great arteries; the ratio between peak velocities during early (E) and late (A) ventricular filling at the level of the atrioventricular values; ventricular fractional shortenings; and output. The findings were compared to age-matched control groups of normal fetuses.


RESULTS
A significant augmentation of interventricular septal thickness was demonstrated for mid-trimester fetuses of diabetic women, which progressed further towards the end of pregnancy. However, the indices of diastolic and systolic function remained comparable between the gestational age-matched groups.


CONCLUSIONS
Progressive myocardial thickening occurs commonly in mid- and late-trimester fetuses of uncomplicated and well-controlled diabetic pregnancies. The observed degree of hypertrophy is generally mild and does not affect age-related changes in fetal cardiac function.
Jaeggi
E T
ET
Fetal Cardiology Unit, Division of Pediatric Cardiology, Sainte-Justine Hospital, University of Montreal, Montreal, Quebec, Canada.
Fouron
J C
JC
Proulx
F
F
D000328:Adult; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D015150:Echocardiography, Doppler; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging / Q000254:growth & development; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011254:Pregnancy in Diabetics / Q000503:physiopathology*; D016216:Ultrasonography, Prenatal