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Item
#3
Dangerous
Cardiovascular Complications Endanger Pregnant Diabetic Women
Early
development of a restrictive pattern of ventricular filling in
pregnant diabetics can lead to complications during delivery.
Whereas pregnancy in healthy women results in a reversible
physiological left ventricular hypertrophy, a disturbed relaxation
pattern and a temporary decrease of left ventricular systolic
function, pregnant women who are diabetic have delayed relaxation
at the beginning of pregnancy and develop a restrictive filling
pattern, say specialists in Düsseldorf, Germany. They studied the
course of haemodynamic parameters under the increased volume load
during pregnancy and delivery in women with insulin-dependent
diabetes.
The specialists examined 51 women with insulin-dependent diabetes
and 51 healthy pregnant women. Fifty one healthy women who were
not pregnant were used as controls.
Left ventricular mass and fractional shortening were calculated
and mitral inflow and pulmonary venous flow profiles were analysed
to evaluate left ventricular diastolic function.
It was found that during pregnancy, left ventricular mass
increased, fractional shortening decreased and diastolic
dysfunction occurred. While the healthy pregnant women developed
signs of disturbed relaxation during pregnancy, pregnant diabetic
women showed signs of a disturbed relaxation at the beginning of
gestation.
Of the 51 pregnant diabetic women, 29 developed a restrictive
ventricular filling pattern at the 24th week of gestation. The
remaining 22 diabetic women had a comparable restrictive filling
pattern only during vaginal delivery.
There were dangerous complications in 10 of the 29 pregnant
diabetic women but no complications in the other 22 diabetic
pregnant women or the healthy pregnant women.
Diabetologia
2003;46:267-275
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