الفهرس 
Diabetes MellitusOnly 14 pages are availabe for public view
 |  | from | 32 |  |  |
| | | from | 32 | | |
Abstract
Diabetes mellitus (DM) is a relatively common medical disorder of pregnancy affecting about 3-7% of the pregnant population.(1) DM has a double impact on the fetal heart. During the period of embryogenesis, DM has a teratogenic effect on the heart. The incidence of congenital cardiac anomalies is five times more than general population. DM impairs the correct expression of genes coding for cardiac development. In addition, it is well documented that infants of diabetic mothers are at risk of developing asymmetric myocardial hypertrophy affecting mainly the interventricular septum even with adequate maternal diabetic control.(2-5)The prevalence of interventricular septum hypertrophy is ~30% even in cases with proper diabetic control.(3) Septal hypertrophy was reported as early as 21 weeks gestational age, but the prevalence is greater in the third trimester. Myocardial hypertrophy involving the right ventricle and the left ventricular posterior wall may occur, but the septal hypertrophy is more marked due to its rich content of insulin receptors.(6)The manifestation of myocardial hypertrophy in the newborn ranges from the lack of symptoms to severe heart failure due to diastolic dysfunction.(7) The severity of the condition is related to the control of diabetes. Microscopic alterations of the hypertrophic myocardium of the infants of diabetic mothers include, in addition to hyperplasia and hypertrophy, a disorganization of the normal pattern of the myofibrils similar to that found in the cardiomyopathy of the adult.(8)Introduction.