Key result
A fetus with cardiac hypertrophy in a type 1 diabetic pregnancy developed severe circulatory insufficiency and acidemia, requiring urgent delivery and fluid resuscitation for survival.
Why the study?
Fetal cardiac hypertrophy in pregnant women with diabetes is believed to be benign, but severe circulatory complications can occur.
Case Report (n=1)
Fetal cardiac hypertrophy in diabetic pregnancies can progress to severe circulatory insufficiency, necessitating careful monitoring with fetal echocardiography to optimize delivery timing.
Severe fetal compromise from CH in type 1 diabetes cautions against assuming benignity; leaves open need for targeted surveillance protocols.
Fetal cardiac hypertrophy (CH) in pregnant women with diabetes is believed to be a benign condition. We encountered a rare case of fetal CH in a pregnant woman with type 1 diabetes, which developed into severe fetal circulatory insufficiency and acidemia. Fetal echocardiography at 37-week gestation showed cardiomegaly with a ventricular hypertrophy. Cardiac function was impaired, and pulsed Doppler findings indicated circulatory failure. The patient was diagnosed with fetal compromise due to fetal CH, and a large for gestational age boy was delivered by an urgent cesarean section. Despite myocardial hyperplasia and left ventricular outflow tract stenosis, the neonate was hemodynamically stabilized by fluid resuscitation alone. Although the neonatal course was favorable, we speculated that the neonate was on the verge of death because he was already acidemic at birth. Therefore, comprehensive fetal echocardiography should be performed in pregnant women with diabetes, and clinicians should not miss the optimal timing of delivery.
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Sakai et al. (2022) conducted a case report in Fetal cardiac hypertrophy in type 1 diabetic pregnancy (n=1). Urgent cesarean section and fluid resuscitation was evaluated on Fetal and neonatal clinical course. A fetus with cardiac hypertrophy in a type 1 diabetic pregnancy developed severe circulatory insufficiency and acidemia, requiring urgent delivery and fluid resuscitation for survival.
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