Several studies have described the association between pre-gestational maternal diabetes and cardiac disease in the newborn.
Infants
of diabetic mothers have an increased incidence
of congenital heart disease, reported between 3% and 6% compared to 0.8%
of the general population. A particularly high prevalence
of conotruncal defects has been recently described among congenital heart diseases. This group
of malformations affects ventricular outflows, aorta, and pulmonary artery and shares a common embryogenic origin. They include persistence
of the truncus arteriosus, transposition
of great arteries, tetralogy
of Fallot, interruption
of the aortic arch, and double outlet right ventricle. Aorto-pulmonary window, a rare congenital heart disease belonging to conotruncal malformations, has never been previously described in association with maternal diabetes. We describe the case
of a male
infant born to a
mother suffering from a poorly controlled type 1 diabetes during pregnancy. In the early postnatal life the
infant showed respiratory distress, tachycardia, and failure to thrive. He was found to be affected by aorto-pulmonary window that required corrective surgical intervention.
<Learning objective: This case report warns us to consider this congenital abnormality as a possible finding in infants born to a diabetic mother. Furthermore, it shows how difficult the echocardiographic diagnosis of aorto-pulmonary windows can be.>