oa Molecular Diagnosis and Vaccines - Relationship between fetal and neonatal cardiac functions and degree of glycemic control in pregnant diabetic women
|Article Title||Relationship between fetal and neonatal cardiac functions and degree of glycemic control in pregnant diabetic women|
|© Publisher:||Egyptian Association of Immunologists|
|Journal||Molecular Diagnosis and Vaccines|
|Affiliations||1 National Heart Institute, Cairo, Egypt|
|Publication Date||Jan 2003|
|Pages||87 - 94|
|Keyword(s)||cardiac function, cardiopulmonary problems, congestive heart failure, fetus, Glycosylated hemoglobin, infant, Pregnancy, gestation diabetes and respiratory distress|
Aim of work was to assess the effect of various degrees of diabetic control during pregnancy on the cardiac function in fetuses and infants at 24-72 hours after birth. Echocardiographic examination of fetuses was done at 6 weeks intervals starting at 20 weeks of gestation in 12 fetuses of good control diabetic women, 5 fetuses of fair control diabetic women and 3 fetuses of poor control diabetic women. Echocardiographic examination was reported at 24-72 hours after birth. Glycosylated hemoglobin of the mothers was estimated early in pregnancy at 8 weeks gestation and then at 8 weeks intervals. Maternal diabetic control was classified into good, fair and poor control according to the maternal Glycosylated hemoglobin levels. Twenty age matched healthy nondiabetic pregnant women and also 20 age and sex matched normal healthy newborns of comparable gestation and birth weight were used. In good control diabetic women the only abnormality found in fetuses and after birth was mild asymmetric septal hypertrophy in 4 cases out of 12 (33%). Three out of 5 in fair control diabetic women showed increased right and left ventricle wall thicknesses (RVW and LVW) and interventricular septum thicknesses (IVS) as well as elevated Right ventricle pre-ejection period/right ventricle ejection time ratio (RPEP/RVET ratio) was consistent with the development of respiratory distress after birth in 3 out of 5. The 3 cases of poor control diabetic women had elevated REW, LVW and IVS thicknesses. Higher than normal in their fetuses and after birth. Two out of the 3 showed elevated Left ventricle pre-ejection period/left ventricle Ejection time ratio (LPEP/LVET ratio) higher than normal in their fetuses and after birth which was consistent with the development of congestive heart failure after birth in them. Elevated RPEP/RVET ratio higher than normal was present in one fetus and after birth in the poor control diabetic woman and this was consistent with the development of respiratory distress after birth in him. There was significant relationship between maternal Glycosylated hemoglobin levels during pregnancy and the cardiac function as well as the clinical severity of cardiopulmonary problems. In conclusion, the degree of glycemic control in pregnant diabetic women affects cardiac function in their fetuses and after birth as well as the clinical severity of cardiac problems postantally.
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