Elevated fetal middle cerebral artery peak systolic velocity in diabetes type 1 patient: a case report

IF 0.1 Q4 OBSTETRICS & GYNECOLOGY

Case Reports in Perinatal Medicine Pub Date : 2021-01-01 DOI:10.1515/crpm-2021-0003

C. Lesmes Heredia, M. Comas Rovira, Anna Moreno Baró, Sílvia Pina Pérez, Marc Zamora Lapiedra, Manuel Corona Martínez

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引用次数: 0

Abstract

Abstract Objectives Doppler measurement of fetal middle cerebral artery peak systolic velocity (MCA-PSV) is used to screen fetuses at risk of developing fetal anemia. This screening tool has demonstrated to be accurate to estimate the likelihood of fetal anemia and it has been used in the management of fetuses at this risk. It is rare to find in the literature cases of increased MCA-PSV in the absence of fetal anemia. We present the case of an elevated MCA-PSV in the absence of common causes of fetal anemia. Case presentation A 30-year-old woman at 21 weeks of gestation was referred to our unit with a left fetal renal agenesis and single umbilical artery diagnosis. The patient had a poorly controlled type 1 Diabetes with a booking HbA1C of 9.1%. At 31 weeks of gestation, MCA-PSV was raised (>1.5 multiples of the median) in the absence of any cause of fetal anemia and discrepancy of ventricular size with normal fetal heart function were seen. In a subsequent scan, thick interventricular septum was seen and hypertrophic cardiomyopathy (HC) was suggested. Follow-up ultrasonography showed a persistent MCA-PSV in a large for gestation age (LGA) fetus with HC. Due to the prenatal diagnosis of persistent elevated MCA-PSV in LGA fetus with diagnoses of HC in a poorly controlled type 1 diabetic patient labor was induced after fetal lung maturation. Biventricular hypertrophic cardiomyopathy was detected after birth. Conclusions HC may be an explanation for increased MCA-PSV without fetal anemia.

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1型糖尿病患者胎儿大脑中动脉收缩速度峰值升高1例报告

目的应用多普勒测定胎儿大脑中动脉收缩压峰值速度(MCA-PSV)来筛查胎儿贫血的危险。这种筛查工具已被证明可以准确地估计胎儿贫血的可能性，并已被用于有这种风险的胎儿的管理。在文献中很少发现在没有胎儿贫血的情况下MCA-PSV升高。我们提出的情况下升高的MCA-PSV在没有常见原因的胎儿贫血。一个30岁的妇女在妊娠21周被转介到我们的单位与左胎肾发育不全和单脐动脉诊断。患者患有控制不良的1型糖尿病，HbA1C为9.1%。在妊娠31周时，在没有任何胎儿贫血原因的情况下，MCA-PSV升高(>中位数的1.5倍)，心室大小与正常胎儿心功能存在差异。在随后的扫描中，发现厚的室间隔和肥厚性心肌病(HC)。随访超声检查显示大胎龄(LGA) HC胎儿存在持续性MCA-PSV。1例控制不良的1型糖尿病患者，由于产前诊断为LGA胎儿伴HC的MCA-PSV持续升高，在胎儿肺成熟后引产。出生后发现双室肥厚性心肌病。结论HC可能是MCA-PSV升高而无胎儿贫血的原因。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Case Reports in Perinatal Medicine OBSTETRICS & GYNECOLOGY-

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期刊介绍： Case Reports in Perinatal Medicine is a double-blind peer-reviewed journal. The objective of the new journal is very similar to that of JPM. In addition to evidence-based studies, practitioners in clinical practice esteem especially exemplary reports of cases that reveal specific manifestations of diseases, its progress or its treatment. We consider case reports and series to be brief reports describing an isolated clinical case or a small number of cases. They may describe new or uncommon diagnoses, unusual outcomes or prognosis, new or infrequently used therapies and side effects of therapy not usually discovered in clinical trials. They represent the basic concept of experiences for studies on representative groups for further evidence-based research. The potential roles of case reports and case series are: Recognition and description of new diseases Detection of drug side effects (adverse or beneficial) Study of mechanisms of disease Medical education and audit Recognition of rare manifestations of disease.