Purpose
Incidence of gestational diabetes mellitus (GDM) varies globally from 2% to 14%.1 In India GDM is emerging as a major public health problem. The prevalence of GDM among urban population of India has been reported as 16% to 17.8%.2 Babies of diabetic mothers are prone to many neonatal and perinatal complications like neonatal hypoglycaemia and hyperbilirubinemia and contractility abnormalities of the cardiac muscle.
Myocardial performance index (MPI) is a Doppler-derived time interval index which has been proposed as a useful predictor of global cardiac function....
Methods and materials
Patient population
44 pregnant women (ages 18 – 35, mean age 26) at 28-38 weeks with either pregestational or gestational diabetes and with no other systemic or pregnancy related disorders were compared with 44 gestational age matched healthy controls by using fetal left ventricular MPI from July 2018 to June 2019.
Inclusion criteria included pregnant women at 28-38 weeks of gestation with pregestational/gestational diabetes mellitus.
Exclusion criteria were maternal anaemia, preeclampsia, multiple pregnancies, IUGR, congenital anomalies.
Data Acquisition – Ultrasound examination was done using GE...
Results
Representative cases
Table 1 summarizes the characteristics of the study population. The two groups were similar for maternal age and gestational ages at assessment. From our study it was found that foetal left ventricular Mod-MPI values were significantly higher in the diabetic group compared with the controls (0.65 ± 0.06 vs 0.50 ± 0.07). There was a statistically significant difference between the 2 groups (P0.58 were having adverse perinatal outcome (sensitivity of 100% & specificity of 90% with 95% confidence interval.) Fig. 7
Mod-MPI serves...
Conclusion
In conclusion, this study has documented abnormal outcomes in pregestational/ gestational diabetic pregnancies with Mod-MPI’s >=0.58. We hypothesize that elevated Mod-MPI can be due to diabetes and it can used as a good predictor of adverse perinatal outcomes. If this has been confirmed by larger prospective trials in different ethnic groups with postnatal echocardiogram follow up ,then Mod-MPI can be used as monitoring method to detect possible foetal deterioration. Apart from previous studies our study was found to have slightly higher MPI cut-off values and...
Personal information and conflict of interest
Athul.D; Chennai, TAMIL NADU/IN - nothing to disclose P. D. J. Devimeenal; Chennai/IN - nothing to disclose K. Gopinathan; Chennai/IN - nothing to disclose D. B. Y. Akash Kumar; Chennai/IN - nothing to disclose D. K. Geetha; Chennai/IN - nothing to disclose D. A. R. Prasan; Chennai/IN - nothing to disclose
References
1.International Diabetes Federation. IDF Diabetes Atlas, Seventh edn. Brussels: IDF, 2015.
2.Mithal A, Bansal B, Kalra S. Gestational diabetes in India: Science and society. Indian J Endocr Metab [serial online] 2015 [cited 2020 Jan 4];19:701-4.
3.Tei C, Ling LH, Hodge DO. New index of combined systolic and diastolic myocardial performance: A simple and reproducible measure of cardial function—a study in normal and dilated cardiomyopathy. J Cardiol 1995;26:357–66.
4.Tei C, Dujardin KS, Hodge DO. Doppler echocardiographic index for assessment of global right ventricular function. J Am...