Abstract
Transient hypertrophic subaortic stenosis due to interventricular septal hypertrophy is an important cause of morbidity in the infant of the diabetic mother (IDM). The purpose of this study was to quantitate left ventricular outflow obstruction through estimation of cardiac output (CO) by pulsed Doppler ultrasound. We evaluated 42 IDMs (White class B, C, D) and compared them to 2 control groups, one comparable in BW and the other similar in GA. Septal hypertrophy was found in 18/42 (43%) of the IDMs. Morbidity increased with advancing septal thickness. Hyaline membrane disease was not present in any of the patients.
With increasing septal thickness, CO/kg diminished linearly (r=-0.78, p<0.001). This was secondary to reduced stroke volumes at comparable heart rates. The IDMs had higher left atrial/aortic ratios and right ventricular systolic time intervals than the control infants.
We conclude that CO is reduced in IDMs with septal hypertrophy. This reduction is secondary to reduced stroke volume due to diminished left ventricular compliance. Pulsed Doppler ultrasound is an important adjunct to the management of symptomatic IDMs.
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Walther, F., Siassi, B., King, J. et al. 153 CARDIAC OUTPUT IN INFANTS OF INSULIN-DEPENDENT DIABETIC MOTHERS. Pediatr Res 19, 136 (1985). https://doi.org/10.1203/00006450-198504000-00183
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DOI: https://doi.org/10.1203/00006450-198504000-00183