Is there a correlation between aortic Doppler velocimetric findings in diabetic pregnant women and fetal outcome?
At present, the role of Doppler velocimetry in monitoring fetal well-being in diabetic pregnancies is controversial. The present study was conducted to determine if fetal aortic velocity waveforms were correlated with fetal outcome in pregnancies complicated by diabetes mellitus. Fetal aortic blood flow was prospectively assessed in 30 pregnant women with insulin-dependent diabetes mellitus. Systolic-diastolic ratios were obtained at 2 week intervals between 18 and 38 weeks of gestation. They were analyzed according to several fetal outcome variables. Infants with presumed fetal distress during labor and neonates with respiratory abnormalities (respiratory distress syndrome, persistent fetal circulation, or transient tachypnea of the newborn) showed statistically significant elevations of aortic Doppler indices (P < 0.031 and < 0.011, respectively). However, these correlations lacked clinical relevance. The infants demonstrated no evidence of fetal distress at birth since Apgar scores were > 7 at 5 min in all but one neonate. No relationship was found between the mean third trimester fetal aortic systolic-diastolic ratios and perinatal death, preterm deliveries, birth weight, Apgar scores at 1 and 5 min, and neonatal metabolic abnormalities. These data demonstrate a poor correlation between fetal aortic Doppler waveform analysis and fetal outcome. Therefore, fetal aortic Doppler velocimetry cannot be used as a means of assessing impending fetal compromise in offspring of diabetic mothers.
Reece
E A
EA
Department of Obstetrics, Gynecology, and Reproductive Sciences, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
Hagay
Z
Z
Moroder
W
W
DeGennaro
N
N
Homko
C
C
Wiznitzer
A
A
D000293:Adolescent; D000328:Adult; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000196:embryology / Q000503:physiopathology*; D001783:Blood Flow Velocity; D003922:Diabetes Mellitus, Type 1 / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005333:Fetus / Q000098:blood supply*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012189:Retrospective Studies; D012212:Rheology; D018608:Ultrasonography, Doppler / Q000379:methods*; D016216:Ultrasonography, Prenatal