Key result
The pulsatility index of ductus venosus was significantly higher in fetuses of diabetic mothers with myocardial hypertrophy (1.28) compared to those without (0.73) and controls (0.59) (P=0.001).
Why the study?
Is the pulsatility index of ductus venosus higher in fetuses of diabetic mothers with myocardial hypertrophy compared to those without hypertrophy and controls?
Cross-Sectional (n=60)
Is the pulsatility index of ductus venosus higher in fetuses of diabetic mothers with myocardial hypertrophy compared to those without hypertrophy and controls?
The pulsatility index of the ductus venosus is significantly elevated in fetuses of diabetic mothers with myocardial hypertrophy, serving as a more useful marker for fetal diastolic dysfunction than mitral and tricuspid E/A ratios.
Supports ductus venosus pulsatility index as marker of fetal diastolic dysfunction in diabetic hypertrophy; hypothesis-generating, requires prospective validation before adoption.
Infants of diabetic mothers have an established risk of developing myocardial hypertrophy even with adequate maternal metabolic control. The pulsatility index of ductus venosus flow may be a useful parameter for assessing the role of myocardial hypertrophy due to maternal diabetes in fetal diastolic ventricular function.Aim of the work: To test the hypothesis that the pulsatility index of ductus venosus (PIDV) is higher and the mitral & tricuspid early diastolic/atrial systole velocity ratios (E/A ratios) are lower in the fetuses of diabetic mothers (FDM) with myocardial hypertrophy (MH) than in the FDM with no MH and in the control fetuses of non-diabetic mothers (FNDM).Subjects and methods: Cross-sectional study included fetuses with gestational ages ranging from 20 to 36 weeks, divided into the following 3 groups: 10 FDM with MH (group I), 20 FDM with no MH (group II), and 30 FNDM (group III, control). The Doppler echocardiogram assessed the PIDV through the ratio (systolic velocity – pre-systolic velocity)/mean velocity. The mitral and tricuspid E/A ratios were also assessed.Results: The mean PIDV in groups I, II, and III were 1.28 ± 0.5, 0.73 ± 0.09, and 0.59±0.09, respectively. Using ANOVA test, the mean pulsatility index was significantly higher in group I than in group II and III (P 0.001). Comparing the pulsatility index of ductus venosus in group II with that in group III, a statistically significant difference (P=0.02) was observed. The mean mitral E/A ratios in groups I, II and III were 0.68 ± 0.04, 0.73 ± 0.06 and 0.68 ± 0.1, respectively. When applying the ANOVA, the mitral E/A ratios were non significant between the three groups (P = 0.17). The mean tricuspid E/A ratios in groups I, II and III were 0.69 ± 0.05, 0.71 ± 0.03 and 0.68 ± 0.07, respectively. When applying the ANOVA, the tricuspid E/A ratios were non significant between the three groups (P = 0.19).Conclusion: DV PI is significantly greater in FDM with MH than in FDM with no MH and in FNDM. It is a useful parameter than E/A ratios of the mitral and the tricuspid valves for assessing fetal diastolic function.
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Rahman et al. (2014) conducted a cross-sectional in Maternal diabetes and fetal myocardial hypertrophy (n=60). Maternal diabetes with fetal myocardial hypertrophy vs. Maternal diabetes without fetal myocardial hypertrophy and non-diabetic controls was evaluated on Pulsatility index of ductus venosus (PIDV) (p=0.001). The pulsatility index of ductus venosus was significantly higher in fetuses of diabetic mothers with myocardial hypertrophy (1.28) compared to those without (0.73) and controls (0.59) (P=0.001).
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