Umbilical artery pulsatility index in pregnancies complicated by insulin-dependent diabetes mellitus without hypertension.
OBJECTIVE
In a group of diabetic pregnant women, the umbilical artery pulsatility index (PI) was compared with both pregnancy complications and perinatal outcomes.


METHODS
We evaluated 67 women with pregnancies complicated by insulin-dependent diabetes mellitus (IDDM), without hypertension. For the study we took the last umbilical PI value before delivery into consideration. Doppler results were not used for patient management. Umbilical artery PI was correlated with the route of delivery and the following perinatal complications: intrauterine growth retardation; cesarean sections for acute fetal distress; respiratory distress syndrome (RDS); neonatal hyperbilirubinemia; hypocalcemia; hypoglycemia; macrosomia, and neonatal intensive care unit (NICU).


RESULTS
Among the 67 diabetic patients enrolled in this study, 44 (66%) had umbilical PIs ranging from the 5th to the 95th percentile (PI mean +/- SD = 1.2 +/- 0.3), while 23 (34%) had PIs above the 95th percentile (PI mean +/- SD = 1.6 +/- 0.3). Among the group with pathologic umbilical PIs, analysis of the data revealed a significantly higher incidence of both cesarean sections for acute fetal distress and perinatal complications: RDS; hyperbilirubinemia; hypoglycemia, and the need for NICU, respectively.


CONCLUSIONS
In 34% of the diabetic pregnant women without hypertension, we found increased vascular resistances. Among these patients the incidence of perinatal complications was higher, and both closer maternal metabolic control and stricter care of fetal conditions are needed.
Fadda
G M
GM
Department of Pharmacology, Gynecology and Obstetrics, University of Sassari, Italy.
Cherchi
P L
PL
D'Antona
D
D
Ambrosini
G
G
Marchesoni
D
D
Capobianco
G
G
Dessole
S
S
D002585:Cesarean Section; D036861:Delivery, Obstetric; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D005260:Female; D005316:Fetal Distress / Q000503:physiopathology; D005317:Fetal Growth Retardation / Q000503:physiopathology; D005320:Fetal Macrosomia / Q000503:physiopathology; D005865:Gestational Age; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006932:Hyperbilirubinemia / Q000503:physiopathology; D006973:Hypertension; D007003:Hypoglycemia / Q000503:physiopathology; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D017078:Laser-Doppler Flowmetry; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000503:physiopathology*; D011673:Pulsatile Flow; D012127:Respiratory Distress Syndrome, Newborn / Q000503:physiopathology; D014469:Umbilical Arteries / Q000503:physiopathology*
D006442:Glycated Hemoglobin