Doppler velocimetry in last trimester pregnancy complicated by insulin-dependent diabetes mellitus.
OBJECTIVE
To study the pulsatility index of the flow velocity waveform of the uterine and umbilical arteries and the fetal aorta in diabetic pregnancy.


METHODS
Twenty-four well-controlled insulin-dependent pregestational diabetics and 25 healthy pregnant women were studied with Doppler ultrasound on two occasions separated by a one month interval in the third trimester. In the study group, a random blood glucose was sampled at the time of the Doppler examination.


RESULTS
At the first Doppler examination the median pulsatility index in the fetal thoracic aorta and in the uterine artery was significantly lower (p < 0.01 and p < 0.05, respectively) in the diabetic group as compared to the healthy controls, whereas the umbilical and uterine artery pulsatility indices were similar. At the second examination, a significant decrease in median pulsatility index of the umbilical artery and the fetal aorta (p < 0.01) and the uterine artery (p < 0.05) was observed in the controls whereas no such change occurred in the diabetics. There was no correlation between glycosylated hemoglobin or random blood glucose and pulsatility index values. An increased incidence of neonatal morbidity was noted in the study group.


CONCLUSIONS
The normal third trimester decline in uteroplacental and fetal placental pulsatility indices was absent in the diabetic group. The pulsatility index was not influenced by blood glucose regulation.
Grunewald
C
C
Department of Obstetrics and Gynecology, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden.
Divon
M
M
Lunell
N O
NO
D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D001786:Blood Glucose / Q000032:analysis; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005333:Fetus / Q000098:blood supply; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D021041:Placental Circulation / Q000502:physiology*; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011254:Pregnancy in Diabetics / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011673:Pulsatile Flow / Q000502:physiology; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging
D001786:Blood Glucose; D006442:Glycated Hemoglobin