SONUÇ ve ÖNERİLER

Elde ettiğimiz bu veriler ışığında DAB‟lerinde her iki ventrikülün fonksiyonları geçiçi ve subklinik de olsa bozulmaktadır. Özellikle, interventriküler septumu kalın olan hasta grubu ile septumu kalın olmayan hasta grubu arasında bazı Doppler parametrelerinin anlamlı olarak fark göstermesi bu patolojiye sahip bebeklerin daha dikkatli gözlenmesi gerektiğini bize göstermektedir. Ancak diyabetik anne bebeklerinde tespit edilen kardiyak disfonksiyonun ADMA düzeyi ile ilişkisi saptanmamıştır.

Çalışmamızdaki diyabetik gebelerin kontrollerinin düzenli olması, kan şekerlerinin regüle olması ve HbA1c düzeylerinin yüksek olmaması bu annelerin bebeklerinde kan ADMA düzeylerinin kontrol grubu ile farklı olmamasına neden olmuş olabilir. Bununla birlikte çalışmamız kesitsel bir çalışma olduğu için ileriye dönük bilgi içermemektedir. Diyabetik anne bebeklerinde Doppler ölçümleri ve ADMA düzeyinin ventrikül fonksiyonlarını değerlendirmeye katkısı ve prognozla ilişkisinin daha ayrıntılı ortaya konulabilmesi için daha fazla olguyu içeren ve uzun süreli prospektif çalışmalara ihtiyaç vardır. Literatürde diyabetik anne bebeklerinde Doppler ölçümleri ve ADMA düzeyinin ventrikül fonksiyonları ile olan ilişkisinin gösterildiği bir çalışmaya rastlamadığımız için bu verilerin literatüre katkı sağlayacağını düşünüyoruz.

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