Multiple structural cardiac malformations in a macrosomic, possibly missed infant of a diabetic mother

Infants of diabetic mothers are prone to cardiac malformations due to teratogenicity of diabetes mellitus (DM). We present here the case of a macrosomic neonate who had marked difficulty with breathing. He had severe hypertrophic cardiomyopathy with patent ductus arteriosus and cor triatriatum dexter, and although his mother had obstetric and a family history suggestive of DM, this diagnosis was not made as her antenatal fasting plasma glucose assay was normal. The need for adequate diagnosis using oral glucose tolerance test or hemoglobin A1c is hereby emphasized.