الفهرس 
Cardiovascular embryologyOnly 14 pages are availabe for public view
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Abstract
Summary
Diabetes mellitus still represents an important medical
problem during pregnancy, causing perinatal morbidity, mortality,
spontaneous abortion, stillbirth and congenital malformations
despite improved outcome reflected by a steep decline
in perinatal mortality over the past few decades, controversy
still exists regarding the care of the pregnant woman with both
pre-existing and gestational Diabetes Mellitus.
Hypertrophic cardiomyopathy found in infants who are
born to diabetic mothers, is mainly related to the poor glycemic
control of maternal diabetes and, consequently to fetal and
neonatal hyperinsulinaemia.
Diabetic fetal cardiomyopathy causes symptoms in 5%
but often transient, with no apparent lasting consequences for
most infants.
Some infants of poorly controlled diabetic mothers experience
significant complications from impaired cardiac function,
such as congestive cardiac failure.
A characteristic feature of hypertrophic cardiomyopathy
in infants of diabetic mothers is hypertrophy of the ventricular
and septal walls. Cardiac hypertrophy is transient with spontaneously
echocardiographic resolution within the first months
after birth, irrespective of therapy.
Hypertrophic cardiomyopathy requires specific management
as digoxin and inotropic agents usually used in heart
failure are contraindicated.
Summary
97
This study aim to study Interventricular septal thickness
in fetus of diabetic mother and correlate it with good glycemic
control. And to correlate postnatal cardiac function to Interventricular
septal thickness to reach cut off value of septal
thickness for prenatal prediction of symptomatic cardiomyopathy
in infant of diabetic mother.
This study carried out on 120 diabetic pregnant ladies
attending to antenatal care clinic or in patient in Aim Shames
University Hospital. The study was carried out on 120 pregnant
women of comparable age and parity. All were singleton
pregnancies of 35 weeks or more. All cases were subjected to
history taking and thorough physical examination. They were
also subjected to ultrasonographic examination for fetal biometric
parameters and for echo examination, the Apgar score
of the newborn was assessed, the body weight was measured
and the fetus was followed up for any complications.
Infants of diabetic mother with poor glycemic control
showed significantly higher mean pre and post natal Interventricular
septum thickness, right and left myocardial thickness
and lower mean Ejection Fraction than those of mother with
good control.
On comparing the difference between pre and post natal
IVS in infants with mother of controlled diabetes and those
with poor control: it showed higher difference in those of uncontrolled
diabetic mothers when compared to infants of controlled
diabetic mothers Fetuses of diabetic women with poor glycemic control
showed significantly thicker IVS (postnatal) when compared
to their prenatal measures
Diabetic mother with poor glycemic control showed
significantly higher rate of distressed infants when compared
to those of diabetic mother with good control.
Diabetic mother with poor glycemic control showed
significantly higher rate of infants large for GA when compared
to those of diabetic mother with good control