DUCTUS VENOSUS FLOW, DIASTOLIC DYSFUNCTION AND MYOCARDIAL HYPERTROPHY IN FETUSES OF DIABETIC MOTHERS | ||
| Zagazig University Medical Journal | ||
| Article 12, Volume 20, Issue 4, July 2014, Pages 1-7 PDF (714.82 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2014.4416 | ||
| Authors | ||
| Mohamed Abdel Rahman1; Abdel Hamed Haroun2; Rasha Kamel3 | ||
| 1Assistant Lecturer of Obstetrics and Gynecology Faculty of medicine, Zagazig University | ||
| 2Professor of Obstetrics and Gynecology Faculty of medicine, Zagazig University | ||
| 3Professor of Obstetrics and Gynecology Faculty of medicine, Cairo University | ||
| Abstract | ||
| 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. | ||
| Keywords | ||
| Ductus venosus, maternal diabetes; fetal myocardial hypertrophy, diastolic dysfunction | ||
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