- Email: [email protected]
Echocardiographic findings in appropriate for gestational age infants of mothers with gestational diabetes
Abstracts
S155
Results
Conclusions
The “growing” and the “pulsatile” pattern were documented respectively in 51 and 86 pts. Ductal closure was observed in 103/137 subjects (75.1%) after one course of ibuprofen. A second course was performed in 22 of these (16.0%). Definitive ductal closure rate with pharmacological approach was 85.6%. Spontaneous ductal closure rate at the time of the first echocardiographic examination was 20.3% of 27 pts. with “pulmonary hypertension” or “closing” pattern, 25 (92.5%) showed spontaneous ductal closure in day 4th. Surgical ligation was performed in 5 pts. (2.4%), all of these with PMA <27 weeks (mean PMA 24.4 < 2.0). Mortality rate in the study group was 18/ 206 (8.7%), incidence of severe ICH and CLD was respectively of 6.3% and 3.8% Residual PDA at discharge was found in 15 subject, 2 of these receiving transcatheter closure at a mean age of 37.3 months.
The AGA infants of mothers with gestational diabetes are at risk of cardiovascular disease.
Conclusions
Ventricular septal defect (VSD) is the most common heart malformation in neonates and infants. A lot of published reports from different authors have shown in neonates high frequency of small, restrictive muscular VSD, significant number of which close spontaneously. Since the 1st August 2007 in the County Hospital in Zakopane in the all the neonates the screening echocardiography is performed. This screening has been possible thanks to European Economic Area GRANTS (Iceland, Lichtenstein, Norway).
Our data showed that ECI was associated with a high closure rate of the ductus and few side effects. Doppler assessment of PDA flow pattern is an important guide in order to predict the risk of developing significant PDA and to reduce the number of patients unnecessarily treated. doi:10.1016/j.earlhumdev.2008.09.401
Abstract UENPS.386 Echocardiographic findings in appropriate for gestational age infants of mothers with gestational diabetes
doi:10.1016/j.earlhumdev.2008.09.402
Abstract UENPS.387 Muscular VSD in neonate-congenital heart defect or a transient problem? Walawski Andrzej⁎, Ksycinski Wieslaw, Anna Hartman-Ksycinska Neonatology Unit, County Hospital, Zakopane, Poland Background and aim
Materials and methods The screening echocardiography was performed. Up to the 30th April 790 neonates were examined. Those with detected muscular VSD were verified after 3 months. Results
Isa Tafreshi Roya⁎ Iran University of Medical Sciences, Tehran, Iran Background and aim Characteristic fetal abnormalities with subsequent excess fetal growth has been showed in infants of diabetic mothers, but a few studies have examined the prevalence of cardiac malformation or dysfunction in appropriate for gestational age (AGA) infants of mothers with gestational diabetes. The aim of this study is to evaluate the cardiovascular malformation in AGA infants born to gestational diabetic mothers. Materials and methods A total of 23 infants (54% male) were included. The control group was 23 healthy full term AGA infants. Echocardiogarphic measurements were obtained in the first 4 days of the birth. Subsequent echocardiographic follow up of babies with cardiac disease was performed at 1, 2 and 4 months.
In our study a small, muscular VSD was found in 10 neonates (1.3%). All the neonates with VSD in our group remained asymptomatic. The only sign of VSD was a typical heart murmur. Only 1 infant had present muscular VSD in 3rd month of life. Conclusions In our opinion a small defect in the muscular segment of venticular septum should not be considered as a heart malformation, as the defect is likely to close during the first 3 months of life. The baby should be closely monitored and the echocardiography should be repeated after three months. In our opinion, the parents of the newborn with small muscular VSD should not be informed that the child has congenital heart defect, because such a information causes a great level of anxiety. The parents should be informed, that the defect is likely to close during the first months of life. doi:10.1016/j.earlhumdev.2008.09.403
Results 54% of mothers managed by dietary modification,20% were treated with oral hypoglycemic agents and 26% were received insulin. Hypoglycemia and hypocalcemia were documented in 48% and 18% of infants of diabetic mothers, respectively. None of the infants showed sever infectious disease or required mechanical ventilation. Septal hypertrophy was present in 34%of infants but none had cardiac specific symptoms. The mean interventricular septum diameter to posterior wall thickness ratio was greater than control (p < 0.05).There was spontaneous regression of ventricular hypertrophy during the first 4 months of life. There was no correlation between degree of metabolic disturbance in mothers and presence of ventricular hypertrophy. Left ventricular systolic function did not differ from those of the control infants. The mean pulmonary artery pressure was higher in infants of diabetic mothers [37 ± 2.mmHg vs.29 ± 3 mmHg (p < 0.04)] but, there was no difference in prevalence of patent ductus arteriosus between two groups.
Abstract UENPS.388 Congenital heart disease with poor outcome in the absence of surgery Anca Bivoleanu⁎,a, VIrlan Anielab, Alexandru Dimitriub, Maria Stamatinc a Neonatal Intensive Care Unit, Iasi, Romania b Departament of Pediatrics, University of Medicine and Pharmacy, Iasi, Romania c Departament of Neonatology, University of Medicine and Pharmacy, Iasi, Romania Background and aim To establish the importance of prenatal and early neonatal diagnosis of severe heart disease, epidemiological and clinical aspects in these babies. Materials and methods Observational study on newborns with severe congenital heart disease admitted in a level three unit, over a three years period. It was quantified the onset of signs and symptoms and clinical evolution.
S155
Results
Conclusions
The “growing” and the “pulsatile” pattern were documented respectively in 51 and 86 pts. Ductal closure was observed in 103/137 subjects (75.1%) after one course of ibuprofen. A second course was performed in 22 of these (16.0%). Definitive ductal closure rate with pharmacological approach was 85.6%. Spontaneous ductal closure rate at the time of the first echocardiographic examination was 20.3% of 27 pts. with “pulmonary hypertension” or “closing” pattern, 25 (92.5%) showed spontaneous ductal closure in day 4th. Surgical ligation was performed in 5 pts. (2.4%), all of these with PMA <27 weeks (mean PMA 24.4 < 2.0). Mortality rate in the study group was 18/ 206 (8.7%), incidence of severe ICH and CLD was respectively of 6.3% and 3.8% Residual PDA at discharge was found in 15 subject, 2 of these receiving transcatheter closure at a mean age of 37.3 months.
The AGA infants of mothers with gestational diabetes are at risk of cardiovascular disease.
Conclusions
Ventricular septal defect (VSD) is the most common heart malformation in neonates and infants. A lot of published reports from different authors have shown in neonates high frequency of small, restrictive muscular VSD, significant number of which close spontaneously. Since the 1st August 2007 in the County Hospital in Zakopane in the all the neonates the screening echocardiography is performed. This screening has been possible thanks to European Economic Area GRANTS (Iceland, Lichtenstein, Norway).
Our data showed that ECI was associated with a high closure rate of the ductus and few side effects. Doppler assessment of PDA flow pattern is an important guide in order to predict the risk of developing significant PDA and to reduce the number of patients unnecessarily treated. doi:10.1016/j.earlhumdev.2008.09.401
Abstract UENPS.386 Echocardiographic findings in appropriate for gestational age infants of mothers with gestational diabetes
doi:10.1016/j.earlhumdev.2008.09.402
Abstract UENPS.387 Muscular VSD in neonate-congenital heart defect or a transient problem? Walawski Andrzej⁎, Ksycinski Wieslaw, Anna Hartman-Ksycinska Neonatology Unit, County Hospital, Zakopane, Poland Background and aim
Materials and methods The screening echocardiography was performed. Up to the 30th April 790 neonates were examined. Those with detected muscular VSD were verified after 3 months. Results
Isa Tafreshi Roya⁎ Iran University of Medical Sciences, Tehran, Iran Background and aim Characteristic fetal abnormalities with subsequent excess fetal growth has been showed in infants of diabetic mothers, but a few studies have examined the prevalence of cardiac malformation or dysfunction in appropriate for gestational age (AGA) infants of mothers with gestational diabetes. The aim of this study is to evaluate the cardiovascular malformation in AGA infants born to gestational diabetic mothers. Materials and methods A total of 23 infants (54% male) were included. The control group was 23 healthy full term AGA infants. Echocardiogarphic measurements were obtained in the first 4 days of the birth. Subsequent echocardiographic follow up of babies with cardiac disease was performed at 1, 2 and 4 months.
In our study a small, muscular VSD was found in 10 neonates (1.3%). All the neonates with VSD in our group remained asymptomatic. The only sign of VSD was a typical heart murmur. Only 1 infant had present muscular VSD in 3rd month of life. Conclusions In our opinion a small defect in the muscular segment of venticular septum should not be considered as a heart malformation, as the defect is likely to close during the first 3 months of life. The baby should be closely monitored and the echocardiography should be repeated after three months. In our opinion, the parents of the newborn with small muscular VSD should not be informed that the child has congenital heart defect, because such a information causes a great level of anxiety. The parents should be informed, that the defect is likely to close during the first months of life. doi:10.1016/j.earlhumdev.2008.09.403
Results 54% of mothers managed by dietary modification,20% were treated with oral hypoglycemic agents and 26% were received insulin. Hypoglycemia and hypocalcemia were documented in 48% and 18% of infants of diabetic mothers, respectively. None of the infants showed sever infectious disease or required mechanical ventilation. Septal hypertrophy was present in 34%of infants but none had cardiac specific symptoms. The mean interventricular septum diameter to posterior wall thickness ratio was greater than control (p < 0.05).There was spontaneous regression of ventricular hypertrophy during the first 4 months of life. There was no correlation between degree of metabolic disturbance in mothers and presence of ventricular hypertrophy. Left ventricular systolic function did not differ from those of the control infants. The mean pulmonary artery pressure was higher in infants of diabetic mothers [37 ± 2.mmHg vs.29 ± 3 mmHg (p < 0.04)] but, there was no difference in prevalence of patent ductus arteriosus between two groups.
Abstract UENPS.388 Congenital heart disease with poor outcome in the absence of surgery Anca Bivoleanu⁎,a, VIrlan Anielab, Alexandru Dimitriub, Maria Stamatinc a Neonatal Intensive Care Unit, Iasi, Romania b Departament of Pediatrics, University of Medicine and Pharmacy, Iasi, Romania c Departament of Neonatology, University of Medicine and Pharmacy, Iasi, Romania Background and aim To establish the importance of prenatal and early neonatal diagnosis of severe heart disease, epidemiological and clinical aspects in these babies. Materials and methods Observational study on newborns with severe congenital heart disease admitted in a level three unit, over a three years period. It was quantified the onset of signs and symptoms and clinical evolution.