Cardiac problems in the offsprings of diabetic mothers : P3127


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Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
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Cardiac problems in the offsprings of diabetic mothers : P3127
Titre de la conférence
15th World Congress of Cardiology
Ullmo S., Di Bernardo S., Roth-Kleiner M., Mivelaz Y., Sekarski N., Vial Y., Meijboom E.J.
Barcelona, Spain, 2-6 September 2006
Statut éditorial
Date de publication
European Heart Journal
Introduction: The group of pregnant women with diabetes is expanding
rapidly mainly because of the increase of patients with Type II (insulin
resistant) and gestational diabetes. The control of glycaemia of future mothers is presumed to diminish the incidence of complications, including prevention of congenital heart disease (CHD) and hypertrophic cardiomyopathy (HCM) of the offsprings. In order to assess the risk of the foetus for CHD and/or HCM we studied the population of mothers with diabetes passing through our perinatal unit between 1.1.2003-31.12.2005.
Methods: A retrospective study of all comers with diabetes was performed. Data were acquired regarding prenatal echocardiographic evaluation, delivery, and postnatal condition, including sequential echocardiographic follow-up.
Results: Included in the study were 75 pregnancies, 80 neonates, of which 16 mothers with Type I, 7 with Type II and 52 with gestational diabetes, of which 35 insulin dependant. HbAc1 levels were between 3.9 and 10.5% (mean 6.5%). Of the 12 pts with HbAc1 above normal 1 had CHD (ASD II) and 6 HCM. 66 neonates had a normal intracardiac anatomy and no signs of HCM. 3 neonates had congenital heart disease (CHD): 1 DORV, 1 VSD diagnosed prenatally and 1 ASD II. HCM was encountered in 11 pts. 1/11 pt with HCM died immediately postnatally and 1/11 pt required premature delivery because of pericardial effusion, RV dilatation and bradycardia. 9/11 had a normal delivery and were followed postnatally for HCM. All of them showed a slow regression of HCM. The 16 Type I pregnancies resulted in 1 neonate with CHD (VSD), 1 death and 1 premature delivery due to HCM and 7 pts with HCM with spontaneous regression. The remaining 8 pts were normal. The neonates of the Type II pregnancies showed in 1 case CHD (ASD), in 3 HCM and 4 were normal.
Of he 52 pregnancies complicated by gestational diabetes 1 pt had a DORV and 1 HCM with spontaneous regression.
Conclusion: An important number of cardiac problems was found in the offspring of all types of diabetic mothers, despite close glucose control. The insufficient effect of preventive glycaemia controls leads us to the conclusion that although no definite predictive parameters for foetal demise or malignant outcome can be presented, close monitoring of these pregnancies may prevent perinatal catastrophes.
Création de la notice
26/01/2010 10:56
Dernière modification de la notice
20/08/2019 15:16
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