[Doppler echocardiographic studies on fetal cardiac function of diabetic mothers]

To assess fetal cardiac function by Doppler echocardiography in diabetic pregnancies.

We investigated the changes of cardiac function in 54 normal fetuses and 23 fetuses of diabetic mothers. Cardiac anatomic datas were obtained by measuring the diameter of the aortic (AO), the pulmonary artery (PA), the mitral valve(MV), the tricuspid valve (TV) and interventricular septal thickness (IVS). Blood flow evlocity were obtained from the AO, PA, atrioventricular valves. The following variables were measured: peak flow velocity (PFV), accelerate time (ACT), systolic volume (SV) and ForceF. These indices respresented the systolic function. The peak early flow velocity (PFVe), peak late flow velocity (PFVa), PFVe/PFVa(E/A), mean velocity (V) of MV or TV respresented the diastolic function.

The results revealed that in fetuses of diabetic mothers, IVS became thickness. The diameter of AO, PA, MV, TV were wider than that of normal fetases. The PFV, SV, ForceF of AO or PA increased significantly. There was no different in ACT between two groups. The PFVa of MV or TV increased significantly, whereas the E/A of both atrioventricular valves decreased.

It showed that the fetal hyperinsulinemia triggered by maternal hyperglycemia result in fetal weight increasing, as well as hyperplasia and hypertrophy of myocardial cells. An iacreased contractility is compatible with relatively larger size of such fetuses. The intracardiac flow volume increased secondary to the more needs of fetal development. Abnormal thickenning IVS might impair ventricular diastolic function.