{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T11:07:14Z","timestamp":1778324834590,"version":"3.51.4"},"reference-count":31,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Gestational diabetes mellitus (GDM) is a form of hyperglycemia that develops during pregnancy and poses risks to both the mother and fetus. In other words, it is a glucose intolerance disorder first recognized during pregnancy, specifically in the second and third trimesters, with approximately 7\u201314% of pregnancies worldwide being affected. Methodology: A systematic literature search was conducted across three major well-established databases; PubMed, Scopus, and ScienceDirect. The search was conducted with the aim of identifying the most suitable studies for the evaluation of fetal cardiac function using Doppler ultrasound techniques in pregnancies affected by GDM. Results: Following a comprehensive full-text assessment, 186 papers were excluded, mainly due to discrepancies in the population, unsuitable study design, publishing type, or unavailability of full-text access. Ultimately, 12 studies met all the inclusion criteria and were incorporated into the scoping review. From the studies included it was found that the conventional pulsed-wave Doppler was the most frequently used modality, assessing parameters such as the E\/A ratios, myocardial performance index (MPI), and the isovolumic relaxation time (IVRT). The advanced techniques of choice included tissue Doppler imaging (TDI), speckle-tracking echocardiography (STE), dual-gate Doppler, and automated MPI. Conclusions: Doppler ultrasound techniques, particularly the advanced modalities like TDI and STE, provide valuable insights into fetal cardiac function in GDM pregnancies. Their integration into routine prenatal surveillance may enhance the early detection of cardiac dysfunction and inform timely clinical interventions.<\/jats:p>","DOI":"10.3390\/jcm14165622","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T15:30:52Z","timestamp":1754667052000},"page":"5622","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Doppler Evaluation of Fetal Cardiac Function in Gestational Diabetes Mellitus: A Scoping Review Providing Insights into Hemodynamic and Structural Alterations"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1703-6980","authenticated-orcid":false,"given":"Sophia","family":"Tsokkou","sequence":"first","affiliation":[{"name":"Laboratory of Histology-Embryology, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1632-821X","authenticated-orcid":false,"given":"Ioannis","family":"Konstantinidis","sequence":"additional","affiliation":[{"name":"Laboratory of Histology-Embryology, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9758-8079","authenticated-orcid":false,"given":"Alkis","family":"Matsas","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Surgery and Surgical Research \u2018N.S. Christeas\u2019, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6215-7464","authenticated-orcid":false,"given":"Evaggelia","family":"Karopoulou","sequence":"additional","affiliation":[{"name":"Second Department of Obstetrics and Gynecology, Aretaieion University Hospital, Medical School, National and Kapodistrian University of Athens, 76 Vasilissis Sofias Avenue, 11528 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0709-5407","authenticated-orcid":false,"given":"Theodora","family":"Papamitsou","sequence":"additional","affiliation":[{"name":"Laboratory of Histology-Embryology, Department of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Choudhury, A.A., and Devi Rajeswari, V. (2021). Gestational diabetes mellitus\u2014A metabolic and reproductive disorder. Biomed. Pharmacother., 143.","DOI":"10.1016\/j.biopha.2021.112183"},{"key":"ref_2","first-page":"331","article-title":"Gestational Diabetes. Obstetrical Perspective","volume":"12","author":"Panaitescu","year":"2016","journal-title":"Acta Endocrinol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S81","DOI":"10.2337\/dc14-S081","article-title":"Diagnosis and Classification of Diabetes Mellitus","volume":"37","author":"Ta","year":"2014","journal-title":"Diabetes Care"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Mao, Y., Hu, W., Xia, B., Liu, L., Han, X., and Liu, Q. (2022). Association Between Gestational Diabetes Mellitus and the Risks of Type-Specific Cardiovascular Diseases. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.940335"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1186\/s12933-022-01663-w","article-title":"Long-term cardiovascular outcomes of gestational diabetes mellitus: A prospective UK Biobank study","volume":"21","author":"Lee","year":"2022","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1007\/s00125-019-4840-2","article-title":"Gestational diabetes and the risk of cardiovascular disease in women: A systematic review and meta-analysis","volume":"62","author":"Kramer","year":"2019","journal-title":"Diabetologia"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"151","DOI":"10.2337\/dc21-1018","article-title":"Gestational Diabetes Mellitus and the Risks of Overall and Type-Specific Cardiovascular Diseases: A Population- and Sibling-Matched Cohort Study","volume":"45","author":"Yu","year":"2022","journal-title":"Diabetes Care"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1002\/bdr2.1435","article-title":"Maternal hyperglycemia and fetal cardiac development: Clinical impact and underlying mechanisms","volume":"110","author":"Basu","year":"2018","journal-title":"Birth Defects Res."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Rodolaki, K., Pergialiotis, V., Iakovidou, N., Boutsikou, T., Iliodromiti, Z., and Kanaka-Gantenbein, C. (2023). The impact of maternal diabetes on the future health and neurodevelopment of the offspring: A review of the evidence. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1125628"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Alnuaimi, S.A., Jimaa, S., and Khandoker, A.H. (2017). Fetal Cardiac Doppler Signal Processing Techniques: Challenges and Future Research Directions. Front. Bioeng. Biotechnol., 5.","DOI":"10.3389\/fbioe.2017.00082"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"E16","DOI":"10.1055\/s-0029-1246106","article-title":"Sonographic Assessment of Fetal Cardiac Function: Indirect Measurements of Fetal Cardiac Function, Newer Techniques and Clinical Applications","volume":"33","author":"Tutschek","year":"2011","journal-title":"Ultraschall Med. Eur. J. Ultrasound"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Tsokkou, S., Konstantinidis, I., Anastasiou, V., Matsas, A., Stamoula, E., Peteinidou, E., Sioga, A., Papamitsou, T., Ziakas, A., and Kamperidis, V. (2025). Fetal Supraventricular Tachycardia: What Do We Know up to This Day?. J. Pers. Med., 15.","DOI":"10.3390\/jpm15080341"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1016\/j.jped.2020.10.003","article-title":"Cardiomyopathy and cardiac function in fetuses and newborns of diabetic mothers","volume":"97","author":"Bogo","year":"2021","journal-title":"J. Pediatr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1002\/pd.4471","article-title":"Use of the myocardial performance index as a prognostic indicator of adverse fetal outcome in poorly controlled gestational diabetic pregnancies","volume":"34","author":"Bhorat","year":"2014","journal-title":"Prenat. Diagn."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e117524","DOI":"10.5812\/ijem-117524","article-title":"Comparison of Parameters of Fetal Doppler Echocardiography Between Mothers with and Without Diabetes","volume":"20","author":"Pooransari","year":"2022","journal-title":"Int. J. Endocrinol. Metab."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2424892","DOI":"10.1080\/14767058.2024.2424892","article-title":"Research on evaluation of fetal right ventricular function in normal and diabetic pregnant women during mid to late pregnancy using automated MPI ultrasound detection technology","volume":"37","author":"Ding","year":"2024","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1017\/S1047951108002138","article-title":"Assessment of diastolic ventricular function in fetuses of diabetic mothers using tissue Doppler","volume":"18","author":"Zielinsky","year":"2008","journal-title":"Cardiol. Young"},{"key":"ref_18","first-page":"276","article-title":"Evaluation of Ventricular Dyssynchrony Measured by Tissue Doppler Indices in Fetuses of Diabetic Mothers: A Case-Control Study","volume":"19","author":"Moghadam","year":"2024","journal-title":"J. Tehran Univ. Heart Cent."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1987","DOI":"10.1007\/s10554-024-03194-9","article-title":"Impact of maternal diabetes mellitus on fetal atrial strain","volume":"40","author":"Pathan","year":"2024","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1002\/uog.20187","article-title":"Perinatal changes in fetal cardiac geometry and function in diabetic pregnancy at term","volume":"54","author":"Patey","year":"2019","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.echo.2017.11.007","article-title":"Fetal Cardiac Function in Maternal Diabetes: A Conventional and Speckle-Tracking Echocardiographic Study","volume":"31","author":"Miranda","year":"2018","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"E26645","DOI":"10.1097\/MD.0000000000026645","article-title":"Assessment of fetal cardiac diastolic function of gestational diabetes mellitus using dual-gate Doppler","volume":"100","author":"Hou","year":"2021","journal-title":"Medicine"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"193","DOI":"10.31083\/j.ceog5109193","article-title":"Assessing Fetal Circulatory Changes in Gestational Diabetes via Aortic Isthmus Doppler","volume":"51","author":"Chen","year":"2024","journal-title":"Clin. Exp. Obstet. Gynecol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e30352","DOI":"10.1016\/j.heliyon.2024.e30352","article-title":"Ultrasonographic diagnosis of fetal hemodynamic parameters in pregnant women with diabetes mellitus in the third trimester of pregnancy","volume":"10","author":"Cai","year":"2024","journal-title":"Heliyon"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"34","DOI":"10.14744\/AnatolJCardiol.2022.2577","article-title":"Modified Myocardial Performance Index in Fetal Growth Disturbances as Diagnostic and Prognostic Adjunct","volume":"27","author":"Simsek","year":"2023","journal-title":"Anatol. J. Cardiol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Maheshwari, P., Henry, A., and Welsh, A.W. (2015). The Fetal Modified Myocardial Performance Index: Is Automation the Future?. Biomed. Res. Int., 2015.","DOI":"10.1155\/2015\/215910"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1002\/uog.3947","article-title":"Gestational-age-adjusted reference values for the modified myocardial performance index for evaluation of fetal left cardiac function","volume":"29","author":"Kottman","year":"2007","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1046\/j.1469-0705.2000.00251.x","article-title":"Tissue Doppler imaging of the fetal heart","volume":"16","author":"Paladini","year":"2000","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/j.echo.2023.04.014","article-title":"Guidelines and Recommendations for Performance of the Fetal Echocardiogram: An Update from the American Society of Echocardiography","volume":"36","author":"Donofrio","year":"2023","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1055\/s-0034-1372430","article-title":"Diagnosis and Treatment of Fetal Arrhythmia","volume":"31","author":"Strasburger","year":"2014","journal-title":"Am. J. Perinatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA Extension for Scoping Reviews (PRISMAScR): Checklist and Explanation","volume":"169","author":"Tricco","year":"2018","journal-title":"Ann Intern Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/16\/5622\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:26:46Z","timestamp":1760034406000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/16\/5622"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,8]]},"references-count":31,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["jcm14165622"],"URL":"https:\/\/doi.org\/10.3390\/jcm14165622","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,8]]}}}