INCIDENCE OF CONGENITAL HEART-DEFECTS IN FETUSES OF DIABETIC MOTHERS - A RETROSPECTIVE STUDY OF 326 CASES

The aim of this study was to quantify the risk of congenital heart dis ease in diabetic mothers referred for fetal echocardiography. Of 326 d iabetic pregnancies seen over a 5-year period, ten (3.1%) resulted in a fetus with congenital heart disease. Nine (90%) of the ten cardiac l esions were identified prenatally, but one fetus had a ventricular sep tal defect that was overlooked antenatally. Postnatal follow-up was ob tained in 312 cases (95.7%). Prenatal echocardiographic examinations w ere performed at 18-38 weeks of gestation (median 25 weeks) and the me dian gestational age at diagnosis of congenital heart disease was 22 w eeks (range 19-30 weeks). Following the detection of a severe cardiac anomaly, the pregnancy was terminated in three cases. Of the seven con tinuing pregnancies, two resulted in spontaneous intrauterine death an d two babies died within the first 6 months of life. The three survivo rs are clinically well, but one has required postnatal catheter interv ention. Our results confirm that diabetic women are at increased risk of having a baby with congenital heart disease and detailed fetal echo cardiography should therefore be offered to all diabetic women during pregnancy.