Comparison of Fetal Echocardiography for Fetal Cardiac Structure in Women with Gestational Diabetes Mellitus and Normal Pregnancies

Increased metabolic rate of hyperglycemia in gestational diabetes causes macrosomia, which can also affect the fetal heart. The thickness of the walls of the heart and its function in women with gestational diabetes mellitus (GDM) can change over time before treatment. We aimed to evaluate fetal cardiac structure in terms of ventricular wall thickness and its function in women with GDM and normal pregnancy for indirect evaluation of the effects of hyperglycemia on the heart.

In this case-control study, pregnant women who referred to Imam Khomeini hospital, Ahvaz, Iran that had normal ultrasound anomaly scan between the ages of 18 to 22 weeks; in 26-28 weeks of pregnancy using 3-hour glucose tolerance test, based on the results were divided into two groups of gestational diabetes (cases, n=45), and normal (control, n=48 group). Fetal echocardiography was performed between the ages of 28 to 32 weeks and the thickness of the ventricular and inter-ventricular septum and the shortening fraction were compared.

Ninety-three pregnant women were participants. The mean age of the subjects was 26.33+ 4.88 years. There was a significant and direct relationship between right ventricular wall thickness, left ventricular thickness and intra ventricular septum, besides, right ventricular fractional shortening increased significantly in the diabetes group compared to the normal pregnancy group (P< 0.05); however, there was no significant difference in left ventricular function between the two groups.

Based on the results, significant increases in the right ventricular wall thickness, left ventricular thickness and intra ventricular septum, as well as right ventricular fractional shortening; which points to the importance of fetal echocardiography in GDM.