The evaluation of fetal interventricular septum with M-mode and spectral tissue Doppler imaging in gestational diabetes mellitus: a case-control study

Deniz Oluklu; Dilek Menekse Beser; Derya Uyan Hendem; Muradiye Yildirim; Duygu Tugrul Ersak; Ezgi Turgut; Dilek Sahin

doi:10.1515/jpm-2023-0306

Article

The evaluation of fetal interventricular septum with M-mode and spectral tissue Doppler imaging in gestational diabetes mellitus: a case-control study

Deniz Oluklu , Dilek Menekse Beser , Derya Uyan Hendem , Muradiye Yildirim , Duygu Tugrul Ersak , Ezgi Turgut and Dilek Sahin

Published/Copyright: October 20, 2023

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From the journal Journal of Perinatal Medicine Volume 52 Issue 2

Abstract

Objectives

To demonstrate possible functional changes in the frequently affected fetal interventricular septum (IVS) with spectral tissue Doppler imaging (TDI) and M-mode imaging to compare gestational diabetes mellitus (GDM) and control groups.

Methods

A total of 63 pregnant women with GDM, 30 on diet (A1 GDM) and 33 on treated with insulin (A2 GDM), and 63 healthy pregnant women randomly selected and matched to the case group in the control group were included.

Results

The GDM fetuses had significantly thickened IVS, increased early diastole (E′), atrial contraction (A′), systole (S′), higher myocardial performance index (MPI′), prolonged isovolumetric relaxation time (IVRT′), shortened ejection time (ET′), and decreased septal annular plane systolic excursion (SAPSE) than the controls. The A2 GDM group fetuses had significantly thickened IVS, increased S′ and shortened ET′ than the A1 GDM group. In the GDM group, we found a significantly positive low correlation between glycated hemoglobin levels and maternal serum fasting glucose and one-hour postprandial glucose with fetal IVS thickness. We demonstrated a significantly negative low correlation between maternal serum one-hour postprandial glucose, glycated hemoglobin levels, and gestational weight gain with fetal IVS ET′.

Conclusions

Fetal IVS diastolic and systolic functions were altered in the GDM group compared to controls, and systolic functions were altered in A2 GDM compared to A1 GDM. This may alert clinicians to possible cardiovascular diseases in the postnatal life, and early preventive strategies and long-term lifestyle changes may provide protection in fetuses with GDM.

Keywords: interventricular septum; cardiac function; M-mode imaging; spectral tissue Doppler imaging; gestational diabetes mellitus

Corresponding author: Associate Professor, Deniz Oluklu, MD, Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health, Ankara City Hospital, 1604th Street, No: 9, 06800 Cankaya/Ankara, Türkiye, Phone: +905442207510, E-mail: denizoluklu9@gmail.com

Research ethics: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013), and has been approved by the authors’ Institutional Review Board (E2-21-637).
Informed consent: Informed consent was obtained from all individuals included in this study.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: The authors state no conflict of interest.
Research funding: None declared.
Data availability: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Received: 2023-07-26

Accepted: 2023-09-12

Published Online: 2023-10-20

Published in Print: 2024-02-26

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Articles in the same Issue

https://doi.org/10.1515/jpm-2023-0306

Keywords for this article

interventricular septum; cardiac function; M-mode imaging; spectral tissue Doppler imaging; gestational diabetes mellitus