Fetal myocardial performance in pregnancies complicated by gestational impaired glucose tolerance.
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. Published by John Wiley & Sons, Ltd.
Wong
M L
ML
Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong, China.
Wong
W H S
WH
Cheung
Y F
YF
D000328:Adult; D001783:Blood Flow Velocity; D016640:Diabetes, Gestational; D015150:Echocardiography, Doppler; D005260:Female; D047109:Fetal Development; D005318:Fetal Heart / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005865:Gestational Age; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D006340:Heart Rate, Fetal; D006801:Humans; D008943:Mitral Valve / Q000000981:diagnostic imaging; D011247:Pregnancy; D014261:Tricuspid Valve / Q000000981:diagnostic imaging; D016216:Ultrasonography, Prenatal