Irish Journal of Medical Science, 2026 (SCI-Expanded, Scopus)
Objective: To compare mitral and tricuspid annular plane systolic excursions (MAPSE and TAPSE, respectively) by using M-mode ultrasonography in fetuses of patients with diet-controlled GDM, insulin-treated GDM and a control group. Methods: This prospective case–control study enrolled 80 women with Gestational diabetes mellitus (GDM) and 95 healthy pregnant controls. Fetal MAPSE and TAPSE were obtained under standardized conditions by experienced operators using M-mode ultrasonography. Results: Fetal mitral annular plane systolic excursion (MAPSE) and tricuspid annular plane systolic excursion (TAPSE) values were found to be significantly lower in the GDM group compared with the control group (p < 0.001). In analyses evaluating GDM cases within themselves, fetal MAPSE and TAPSE values were found to be more significantly reduced in the insulin-treated GDM group compared to the diet-controlled GDM group. Conclusion: Fetal MAPSE and TAPSE values, measured by M-mode ultrasonography, were found to be significantly lower in the GDM group compared to the control group. The more pronounced decrease in these values, particularly in insulin-treated GDM cases, suggests that M-mode-derived MAPSE and TAPSE may serve as practical adjunctive markers of altered fetal cardiac function in GDM; however, their routine clinical use requires further validation with reproducibility analyses and postnatal outcome data.