Abstract
Impaired maternal glucose metabolism during pregnancy can have significant effects on the cardiovascular system of the developing fetus. Early in pregnancy the teratogenic effects may lead to structural heart defects, while later in gestation a form of hypertrophic cardiomyopathy can develop due to overgrowth driven by fetal hyperinsulinism. We describe an infant with the uncommon combination of both dextro-transposition of the great arteries and hypertrophic cardiomyopathy. We emphasize the importance of a longitudinal multi-disciplinary approach, from fetal diagnosis to post-operative management, that allowed for an excellent outcome in this rare combination of severe cardiac malformations.
Similar content being viewed by others
References
Wren C, Birrell G, Hawthorne G (2003) Cardiovascular malformations in infants of diabetic mothers. Heart 89(10):1217–1220
Ferencz C, Neill CA (1992) Cardiomyopathy in infancy: observations in an epidemiologic study. Pediatr Cardiol 13(2):65–71
Loffredo CA, Wilson PD, Ferencz C (2001) Maternal diabetes: an independent risk factor for major cardiovascular malformations with increased mortality of affected infants. Teratology 64(2):98–106
Ferencz C (1990) A case-control study of cardiovascular malformation in live born infants: the morphogenic relevance of epidemiological findings, 1st edn. Futura Publishing Company, Mount Kisco
Ullmo S et al (2007) Pathologic ventricular hypertrophy in the offspring of diabetic mothers: a retrospective study. Eur Heart J 28(11):1319–1325
Gutgesell HP, Speer ME, Rosenberg HS (1980) Characterization of the cardiomyopathy in infants of diabetic mothers. Circulation 61(2):441–450
Weatherall DJ, Ledingham JGG, Warrell DA (1987) Oxford textbook of medicine, 2nd edn. Oxford medical publications Oxford University Press, Oxford, New York
Cedergren MI, Kallen BA (2006) Obstetric outcome of 6346 pregnancies with infants affected by congenital heart defects. Eur J Obstet Gynecol Reprod Biol 125(2):211–216
Mills JL, Baker L, Goldman AS (1979) Malformations in infants of diabetic mothers occur before the seventh gestational week. implications for treatment. Diabetes 28(4):292–293
Mills JL (1982) Malformations in infants of diabetic mothers. Teratology 25(3):385–394
Mehta A, Hussain K (2003) Transient hyperinsulinism associated with macrosomia, hypertrophic obstructive cardiomyopathy, hepatomegaly, and nephromegaly. Arch Dis Child 88(9):822–824
Sardesai MG et al (2001) Fatal hypertrophic cardiomyopathy in the fetus of a woman with diabetes. Obstet Gynecol 98(5 Pt 2):925–927
Chaudhari M, Brodlie M, Hasan A (2008) Hypertrophic cardiomyopathy and transposition of great arteries associated with maternal diabetes and presumed gestational diabetes. Acta Paediatr 97(12):1755–1757
Shu LP et al (2020) Maternal diabetes mellitus and persistent pulmonary hypertension of the newborn: accumulated evidence from observational studies. Can J Diabetes 44(4):327-334 e3
Spoladore R et al (2012) Pharmacological treatment options for hypertrophic cardiomyopathy: high time for evidence. Eur Heart J 33(14):1724–1733
Flamm MD, Harrison DC, Hancock EW (1968) Muscular subaortic stenosis. Prevention of outflow obstruction with propranolol. Circulation 38(5):846–858
Adelman AG et al (1970) Long-term propranolol therapy in muscular subaortic stenosis. Br Heart J 32(6):804–811
Thompson DS et al (1980) Effects of propranolol on myocardial oxygen consumption, substrate extraction, and haemodynamics in hypertrophic obstructive cardiomyopathy. Br Heart J 44(5):488–498
Way GL et al (1979) The natural history of hypertrophic cardiomyopathy in infants of diabetic mothers. J Pediatr 95(6):1020–1025
Gardiner HM (2015) Prenatal diagnosis of critical isolated congenital heart disease: dismantling silos to provide better care. Ultrasound Obstet Gynecol 45(6):627–628
Sethi N et al (2021) Standardized delivery room management for neonates with a prenatal diagnosis of congenital heart disease: a model for improving interdisciplinary delivery room care. J Neonatal Perinatal Med 14(3):317–329
Sanapo L, Moon-Grady AJ, Donofrio MT (2016) Perinatal and delivery management of infants with congenital heart disease. Clin Perinatol 43(1):55–71
Sanapo L et al (2017) Fetal echocardiography for planning perinatal and delivery room care of neonates with congenital heart disease. Echocardiography 34(12):1804–1821
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors did not receive support from any organization for the submitted work. The authors have no relevant financial or non-financial conflicts of interests to disclose.
Ethical Approval
The authors have no competing interests to declare that are relevant to the content of this article.
Informed consent
Informed consent was obtained from the parents for submission of the case report to this journal.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Bigelow, A.M., Ball, M.K., Galantowicz, M. et al. Management of Hypertrophic Cardiomyopathy in a Newborn with Dextro-Transposition of the Great Arteries. Pediatr Cardiol 43, 926–929 (2022). https://doi.org/10.1007/s00246-022-02874-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00246-022-02874-4