Evaluation of ultrasonographic fetal cardiac morphometry in the third trimester pregnanci̇es compli̇cated with diabetes and the determination of perinatal results

To evaluate the ultrasonographic fetal cardiac morphometry and fetal doppler parameters in pregnant women complicated with gestational diabetes in the third trimester and to compare the pregnancy results. The study was designed as a prospective cohort study. Eigthyseven voluntary, single-pregnancy pregnant patients between ages 18-40 year who applied to the obstetrics outpatient clinic of Gazi University Faculty of Medicine, Department of Obstetrics and Gynecology were included. Pregnant women were divided into three groups as control, diet-regulated GDM and insulin-regulated GDM. Fetal biometric measurements, Doppler and cardiac morphological measurements of the patients in all groups were taken and recorded during the 34- 37. week of gestation. The mean age was 31.1 ± 3.12 in the control group, 31.27 ± 5.23 in the diet-regulated GDM group, and 31.92 ± 5.3 in the insulin-regulated GDM group (p = 0.764). Z scores of the mitral valve, RVEDD, LVEDD and ascending aorta were statistically significantly different in both diet-regulated GDM group and the insulin-regulated GDM group compare to controls (p=<0,001, p=0,002, p=<0,001, p=0,003 respectively) . Left ventricular base-apex, left ventricular area, right ventricular area Z scores were found to be different between the groups, and in the subgroup analysis, the statistically significant difference was only found between the insulin-regulated GDM group and the control group (p=0,003, p=0,003, p=0,005 respectively). Right and left ventricular sphericity index was not different between groups (p = 0.751, p = 0.200 respectively). The thickness of the interventricular septum both in the systole and in the diastole (p=<0,001, p=<0,001 respectively) and left and rigth ventricular wall thickness increased significantly in both diet-regulated GDM group and the insulin-regulated GDM group compare to controls (p=<0,001, p=<0,001 respectively). There was no difference between the groups in terms of umbilical artery S / D, umbilical artery PI, MCA PI, ductus venosus PI values , MCA PSV MoM (respectively p=0,339 , p=0,525, p=0,238, p=0,850, p=0,846) . GDM caused thicker ventricular walls and shorter and narrower ventricules compare to normal. These effects are similar in both diet-regulated GDM group and the insulin-regulated GDM group Keywords: Gestational diabetes; Fetal cardiac morphology; Fetal cardiac Z score