Echocardiographic Evaluation of Fetal Cardiac Structure and Function in Pregnant Women with Hyperglycemia

Objective: To evaluate differences in various fetal echocardiographic parameters in women with or without hyperglycemia during pregnancy.Material and Methods: We studied fetal cardiac structure and function in 50 uncomplicated singleton pregnancies and in 100pregnancies complicated by hyperglycemia.Maternal glycemic control was deemed adequate in 80 women and inadequate in 20.Fetal echocardiography was done to assess interventricular septal thickness and cardiac function, both systolic [ejection fraction (EF)] and diastolic [using E/A ratio, Ea value and E/Ea ratio].All these parameters were compared between groups.Results: Fetal cardiac interventricular septal thickness during diastole was increased in hyperglycemicas compared to normal pregnant females (p value<0.05) and it was independent of glycemic control.Fetal cardiac systolic function as indicated by ejection fraction was also increased in hyperglycemic pregnant females (p value<0.05)but it was found to be decreased in uncontrolled diabetic females.Fetal cardiac diastolic dysfunction as indicated by low E/A ratio, low Ea value and increased E/Ea ratio was present in pregnant females with hyperglycemia and it was dependent on glycemic control of the patient (p value<0.05).Conclusion: Fetuses of diabetic mothers have increased incidence of cardiac dysfunction and it was related to control of diabetes.