FETAL ECHOCARDIOGRAPHIC ANALYSIS OF MYOCARDIAL THICKNESS AND SEPTAL INTEGRITY IN GESTATIONAL DIABETIC PATIENTS AND ITS ASSOCIATION WITH FAMILY HISTORY OF DIABETES

Abstract

Background: Gestational diabetes mellitus (GDM) is a frequent metabolic complication of pregnancy and is strongly linked to adverse fetal outcomes, including structural and functional cardiac alterations. While the impact of maternal hyperglycemia on fetal cardiac development has been extensively documented, the additional role of genetic predisposition through a positive family history of diabetes (FHD) has received limited attention. Investigating this interaction is particularly important in high-risk populations such as Pakistan, where diabetes prevalence is alarmingly high.

Objective: The objective of this study was to evaluate fetal echocardiographic parameters, including interventricular septal (IVS) thickness, left ventricular end-diastolic diameter (LVDd), ejection fraction (EF), and fractional shortening (FS), and to determine their association with family history of diabetes in women with GDM.

Methods: A prospective cross-sectional study was carried out in the Echocardiography Department of The Children’s Hospital, Lahore, over a two-month period. A total of 89 pregnant women aged 20–45 years with singleton pregnancies between 18–36 weeks of gestation were recruited using purposive sampling. Fetal echocardiography was performed using a 3–5 MHz transducer, with standard cardiac views and Doppler assessment to measure IVS thickness, LVDd, EF, and FS. Maternal demographic data and family history of diabetes were systematically recorded. Statistical analysis was conducted using SPSS version 30, applying descriptive statistics and Chi-square tests, with significance set at p < 0.05.

Results: Among the 89 participants, 77 (86.5%) reported a positive FHD and 12 (13.5%) had no such history. Septal hypertrophy was identified in 74 women (83.15%) with FHD compared to 9 (10.11%) without, demonstrating a significant association (p = 0.007). LVDd values showed similar significance (p = 0.006), with 50 (56.18%) of women with FHD exhibiting reduced dimensions compared to 5 (5.62%) without. In contrast, EF and FS were preserved across both groups, showing no statistical association with family history (p = 0.691).

Conclusion: The study concluded that GDM in combination with a positive family history of diabetes significantly influenced fetal cardiac morphology, particularly septal hypertrophy and reduced LVDd, while systolic parameters such as EF and FS remained unaffected. These findings highlight the importance of enhanced prenatal surveillance and targeted echocardiographic screening in high-risk pregnancies.