title: Use of fetal echocardiography for characterization of fetal cardiac structure in women with normal pregnancies and gestational diabetes mellitus.
abstract: OBJECTIVE
  To assess fetal cardiac structure and function and to evaluate the efficacy of routine fetal echocardiography for detection of fetal cardiac abnormalities in women with normal pregnancies and those with gestational diabetes mellitus.
  
  
  METHODS
  In this prospective study, we studied fetal cardiac structure and function in 294 uncomplicated singleton pregnancies and 302 pregnancies complicated by gestational diabetes. Fetal echocardiography (2-dimensional sonography and pulsed wave Doppler imaging) was used to assess functional parameters and to detect any cardiac structural abnormality. Data from clinical and echocardiographic evaluations of neonates at birth and 3 months were obtained to confirm the antenatal findings.
  
  
  RESULTS
  The mean maternal age ± SD was 28.9 ± 5.0 years in the diabetes group and was comparable to that of women with normal pregnancies. The mean hemoglobin A1c value was 6.3%, and the mean body mass index was 28.0 kg/m(2). The systolic function as assessed by the ejection fraction increased significantly in the diabetes group compared to the normal pregnancy group independent of glycemic control (P < .001). The pulsed wave parameters (early diastolic peak flow velocity and early-to-late diastolic peak flow velocity ratio) were significantly different between the groups (P < .001). The interventricular septum and fetal ventricular wall thicknesses were significantly increased in the presence of gestational diabetes (P < .001). No major fetal cardiac structural anomaly was detected in either group. On follow-up after delivery, all neonates were assessed clinically and by transthoracic echocardiography to rule out congenital defects.
  
  
  CONCLUSIONS
  In our study, significant increases in the interventricular septum and ventricular wall thicknesses were detected in the presence of gestational diabetes mellitus. Interestingly, none of the neonates of pregnant women with gestational diabetes were found to have echocardiographic evidence of congenital heart disease.
authors: Command Hospital, Lucknow, India (S.G.); Department of Medicine, Armed Forces Medical College, Pune, India (P.S., V.B.); Department of Cardiology, Ulster Hospital, Belfast, Northern Ireland (D.S.); Ruby Hall Clinic, Grant Medical Foundation, Pune, India (M.D.); and Department of Cardiology, Artemis Health Institute, Gurgaon, India (A.D.).
authors: Salil
authors: S
authors: Garg
authors: Command Hospital, Lucknow, India (S.G.); Department of Medicine, Armed Forces Medical College, Pune, India (P.S., V.B.); Department of Cardiology, Ulster Hospital, Belfast, Northern Ireland (D.S.); Ruby Hall Clinic, Grant Medical Foundation, Pune, India (M.D.); and Department of Cardiology, Artemis Health Institute, Gurgaon, India (A.D.). drprafullsharma@gmail.com.
authors: Prafull
authors: P
authors: Sharma
authors: Command Hospital, Lucknow, India (S.G.); Department of Medicine, Armed Forces Medical College, Pune, India (P.S., V.B.); Department of Cardiology, Ulster Hospital, Belfast, Northern Ireland (D.S.); Ruby Hall Clinic, Grant Medical Foundation, Pune, India (M.D.); and Department of Cardiology, Artemis Health Institute, Gurgaon, India (A.D.).
authors: Divyesh
authors: D
authors: Sharma
authors: Command Hospital, Lucknow, India (S.G.); Department of Medicine, Armed Forces Medical College, Pune, India (P.S., V.B.); Department of Cardiology, Ulster Hospital, Belfast, Northern Ireland (D.S.); Ruby Hall Clinic, Grant Medical Foundation, Pune, India (M.D.); and Department of Cardiology, Artemis Health Institute, Gurgaon, India (A.D.).
authors: Vineet
authors: V
authors: Behera
authors: Command Hospital, Lucknow, India (S.G.); Department of Medicine, Armed Forces Medical College, Pune, India (P.S., V.B.); Department of Cardiology, Ulster Hospital, Belfast, Northern Ireland (D.S.); Ruby Hall Clinic, Grant Medical Foundation, Pune, India (M.D.); and Department of Cardiology, Artemis Health Institute, Gurgaon, India (A.D.).
authors: Manuel
authors: M
authors: Durairaj
authors: Command Hospital, Lucknow, India (S.G.); Department of Medicine, Armed Forces Medical College, Pune, India (P.S., V.B.); Department of Cardiology, Ulster Hospital, Belfast, Northern Ireland (D.S.); Ruby Hall Clinic, Grant Medical Foundation, Pune, India (M.D.); and Department of Cardiology, Artemis Health Institute, Gurgaon, India (A.D.).
authors: Anil
authors: A
authors: Dhall
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D016640:Diabetes, Gestational / Q000000981:diagnostic imaging*; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging*; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal / Q000379:methods*
keywords: congenital heart defects; diabetes; fetal echocardiography; gestational diabetes; obstetric ultrasound; pregnancy