gynecology and obstetrics medical project, gynecology journal, obstetrics, gynecologic oncology, reproductive medicine, gynecological endoscopy, ultrasonography, gynecology articles

Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

Doppler study of fetal cardiac dysfunction in gestational diabetes and its effect on perinatal outcome


Author(s): Nagy Mohammed Metwally Ahmed*

Background: Diabetes in pregnancy is unique because of the diversity of problems that can affect fetus beginning with conception. Babies born to diabetes mothers commonly have heart damage. Whether this is caused by inadequate glucose regulation is still up for debate.

Objective: To correlate Doppler study of fetal ductus venosus, IVC and interventricular septum thickness with fetal cardiac dysfunction in controlled and uncontrolled diabetic pregnancy.

Methods: This study included 200 women from diabetes (N =140) and non-diabetes (N=60). Both groups are with singleton pregnancies without major malformations. They classified into: group I (N=60 women with normal pregnancies), group II (N=60 women with controlled diabetes) and group III (N=80 women with uncontrolled diabetes). Diagnostic criteria of maternal diabetes mellitus followed American College of Obstetricians and Gynecologists Guidelines. For all women, the following was done: Routine history taking, general, obstetric examination, routine investigations, ultrasound scanning of fetal viability, and measurement of cardiac interventricular septum thickness (the 4-chamber view), Dopper velocimetry (P/I) for of ductus venosus and APGAR score.

Results: The following were statistically significant difference. in group III, The femur length, the head circumference, the abdominal circumference, and AFI was significantly greater than that in groups I and II. Group III had a statistically significant mitral E wave peak flow than groups I and II. Group III had a statistically significant tricuspid E wave peak flow than groups I and II.

Conclusion: Fetuses of mothers with uncontrolled diabetes have impaired in ductus venosus flow with an increase in the pulsatility index of that flow as compared with fetuses of mothers with controlled diabetes and normal fetuses of non-diabetic mothers. It can be used for assessment of diastolic dysfunction in fetuses of diabetic mothers.