A Rare Case of Fetal Cardiac Hypertrophy Developing into Acute Circulatory Insufficiency and Fetal Compromise in Type 1 Diabetic Pregnancy

1. a

Figure 4: Echocardiograph of the neonatal heart. (a) Although cardiac

contraction was adequate, myocardial hyperplasia and left ventricular

outflow tract stenosis were observed on day 1. (b) Interventricular septal

thickening was improved, and the left ventricular cavity was enlarged

on day 19

Figure 5: Chest radiograph of the neonate. Cardiomegaly was gradually

ameliorated

volume expansion alone, and the CH spontaneously regressed.

Although a favorable clinical course was obtained postnatally,

we believe that the fetus presented in this case report was on

the verge of death because he was already acidemic at birth.

In conclusion, our experience suggests that a careful structural

and functional evaluation of the fetal heart in pregnant women

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Ullmo S, Vial Y, Bernardo SD, Roth‑Kleiner M, Mivelaz Y, Sekarski N.

et al., Pathologic ventricular hypertrophy in the offspring of diabetic

mothers: A retrospective study. Eur Heart J 2007;28:1319‑25.

2. Russell NE, Holloway P, Quinn S, Foley M, Kelehan P, McAuliffe FM.

Cardiomyopathy and cardiomegaly in stillborn infants of diabetic

mothers. Pediatr Dev Pathol 2008;11:10‑4.

3. Chanthasenanont A, Somprasit C, Pongrojpaw D. Nomograms of the

fetal heart between 16 and 39 weeks of gestation. J Med Assoc Thai

2008;91:1774‑8.

4. Eidem BW, Edwards JM, Cetta F. Quantitative assessment of fetal

ventricular function: Establishing normal values of the myocardial

performance index in the fetus. Echocardiography 2001;18:9‑13.

5. Paauw ND, Stegeman R, de Vroede MA, Termote JU, Freund MW,

Breur JM. Neonatal cardiac hypertrophy: The role of hyperinsulinism‑a

review of literature. Eur J Pediatr 2020;179:39‑50.

6. Gutgesell HP, Speer ME, Rosenberg HS. Characterization of

the cardiomyopathy in infants of diabetic mothers. Circulation

1980;61:441‑50.

7. Garcia‑Flores J, Jañez M, Gonzalez MC, Martinez N, Espada M,

Gonzalez A. Fetal myocardial morphological and functional changes

associated with well‑controlled gestational diabetes. Eur J Obstet

Gynecol Reprod Biol 2011;154:24‑6.

8. Sanhal CY, Daglar HK, Kara O, Uygur D, Yucel A. Assessment of

fetal myocardial performance index in women with pregestational and

gestational diabetes mellitus. J Obstet Gynaecol Res 2017;43:65‑72.

9. Miranda JO, Cerqueira RJ, Ramalho C, Areias JC, Henriques‑Coelho T.

Fetal cardiac function in maternal diabetes: A conventional and

speckle‑tracking echocardiographic study. J Am Soc Echocardiogr

2018;31:333‑41.

10. Lipshultz SE, Orav EJ, Wilkinson JD, Towbin JA, Messere JE,

Lowe AM. et al., Risk stratification at the time of diagnosis

for children with hypertrophic cardiomyopathy: A report from

the Pediatric Cardiomyopathy Registry Study Group. Lancet

2013;382:1889‑97.

Journal of Medical Ultrasound ¦ Volume 30 ¦ Issue 2 ¦ April‑June 2022

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