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评估妊娠前和妊娠糖尿病患者右心室内膜运动功能指数。

Evaluation of right side foetal myocardial performance index in pregestational and gestational diabetes mellitus.

机构信息

Department of Perinatology, Osmangazi University, Eskişehir, Turkey.

Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey.

出版信息

J Obstet Gynaecol. 2022 Jan;42(1):91-96. doi: 10.1080/01443615.2021.1882971. Epub 2021 May 2.

Abstract

The aim of our study is to investigate the myocardial performance index (MPI) of the right side of the foetal heart in pregestational and gestational diabetes mellitus and to compare it with non-diabetic pregnancies. This prospective cross-sectional study was conducted between August 2018 and March 2019 at Kanuni Sultan Suleyman Research and Training Hospital. Women with pregestational or gestational diabetes mellitus at 24-34 weeks of gestation were included in the study and non-diabetic pregnant women were included as the control group. MPI of the right side of the foetal heart were evaluated and compared between the groups. A total of 65 pregestational or gestational diabetic patients and 65 non-diabetic patients were included in the study. Isovolumetric contraction time and isovolumetric relaxation time values were significantly longer in the diabetic group ( < .001). Ejection time values were significantly shorter in the diabetic group ( < .001). MPI values were significantly higher in the diabetic group than the non-diabetic group ( < .001). In conclusion, MPI of the right side of the foetal heart is significantly higher in pregestational and gestational diabetes than in the non-diabetic group.IMPACT STATEMENT Gestational diabetes mellitus causes foetal cardiomyopathy and foetal diastolic dysfunction. Myocardial performance index (MPI) is a non-invasive, Doppler-derived myocardial performance assessment that is independent of both heart rate and ventricular anatomy. MPI of the right side of the foetal heart was significantly higher in pregestational and gestational diabetes than in the non-diabetic group. There was no difference in right ventricular MPI between pregestational and gestational groups in diabetic pregnancies, and between insulin using and not insulin using groups. Our study results are promising. MPI of the right side of the foetal heart is significantly higher in pregestational and gestational diabetes than in the non-diabetic group. Prospective cohort studies evaluating serial MPI and evaluating by postpartum foetal echocardiography are needed to evaluate possible adverse effects of diabetes on foetal cardiac functions.

摘要

本研究旨在探讨妊娠前和妊娠糖尿病胎儿右心的心肌做功指数(MPI),并将其与非糖尿病妊娠进行比较。这项前瞻性的病例对照研究于 2018 年 8 月至 2019 年 3 月在 Kanuni Sultan Suleyman 研究与培训医院进行。将 24-34 周妊娠的妊娠前或妊娠糖尿病妇女纳入研究,并将非糖尿病孕妇纳入对照组。评估并比较两组胎儿右心 MPI。共纳入 65 例妊娠前或妊娠糖尿病患者和 65 例非糖尿病患者。糖尿病组等容收缩时间和等容舒张时间明显延长(<0.001)。糖尿病组射血时间明显缩短(<0.001)。糖尿病组 MPI 值明显高于非糖尿病组(<0.001)。结论:与非糖尿病组相比,妊娠前和妊娠糖尿病胎儿右心 MPI 明显升高。

意义陈述:妊娠糖尿病可导致胎儿心肌病和胎儿舒张功能障碍。心肌做功指数(MPI)是一种非侵入性、多普勒衍生的心肌做功评估方法,独立于心率和心室解剖结构。与非糖尿病组相比,妊娠前和妊娠糖尿病胎儿右心 MPI 明显升高。在糖尿病妊娠中,右心室 MPI 在妊娠前和妊娠组之间没有差异,在使用胰岛素和不使用胰岛素组之间也没有差异。我们的研究结果很有前景。与非糖尿病组相比,妊娠前和妊娠糖尿病胎儿右心 MPI 明显升高。需要前瞻性队列研究评估连续 MPI 并通过产后胎儿超声心动图评估,以评估糖尿病对胎儿心功能的潜在不良影响。

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