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1144 Cardiac Involvement in Newborn of Diabetic Mother: Diagnosis And Follow Up Of Evolution
  1. L Dimitriu1,
  2. AG Dimitiru2
  1. 1Pediatric Cardiology, Medex Medical Center
  2. 2Pediatric Cardiology, University of Medicine and Pharmacy, Iasi, Romania

Abstract

Objectives To present the main aspects of diagnosis and follow up of cardiac involvement in newborn of diabetic mothers (IDMs).

Methods/patients 84 IDMs investigated in the first week of life and re evaluated at 6–12 month (49), by clinical exam, ECG, cardiothoracic radiography (Rx.CT) and Doppler echocardiography (Echo). Fetal echo was performed in 38 cases.

Results Fetal Echo showed: cardiomegaly and myocardial hypertrophy of left ventricle (LV) (11 cases) confirmed by postnatal Echo. Clinical exam in newborn: macrosomia (40%), systolic murmur (32 cases), signs of heart failure (3), others being asymptomatic or non cardiac symptoms. ECG: LV hypertrophy (14 cases). Rx.CT: cardiomegaly (12). Echo showed: non obstructive hypertrophic cardiomyopathy (HCMP) with asymmetric IVS hypertrophy (42%), arterial pulmonary hypertension (6), LV diastolic dysfunction with normal systolic function (52%) and congenital cardiac anomalies in 17% cases. HCMP was not correlated with the type of mother’s diabetes, before pregnancy or gestational, but rather to an inadequate control of disease. Control performed at 6–12 months (21 cases): normal morphological cardiac aspect (14) or significant reduction of HCMP (7), with normal diastolic and systolic LV function.

Conclusions IDMs presents a high risk for cardiac involvement, either cardiac congenital malformations (17%) or acquired cardiac pathology: HCMP (43%) and disturbances of diastolic function of LV (54%) and justify early cardiologic screening for all of these newborns with or without of cardiac suffering symptoms. Fetal and post natak Echo are the most sensitive and noninvasive methods of diagnostic and follow up on IDMs cardiac diseases.

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