Placental and fetal pulsatility indices in gestational diabetes mellitus.
OBJECTIVE
To assess the usefulness of placental and fetal Doppler velocimetry in the surveillance of gestational diabetes mellitus (GDM).


METHODS
We studied 89 patients with GDM. All fetuses underwent umbilical, fetal descending thoracic aorta and fetal middle cerebral artery pulsatility index (PI) assessment. Doppler results were not used for management. We correlated PI with route of delivery and with the following perinatal complications: small size for gestational age, cesarean section (CS) for acute fetal distress (AFD), respiratory distress syndrome, hyperbilirubinemia, hypocalcemia, hypoglycemia, macrosomia and stay in a neonatal intensive care unit.


RESULTS
Seventy-seven patients (87%) had normal Doppler measurements, while 12 (13%) showed one or more abnormal measurements. The greatest incidence of CS for AFD (42% vs. 16%, P < .001), as well as neonatal hyperbilirubinemia (25% vs. 10%, P < .001) and hypoglycemia (25% vs. 5%, P < .001) was reported among the women with abnormal Doppler measurements.


CONCLUSIONS
Fetal placental hemodynamics are normal in most cases of GDM. In a small percentage of cases we observed abnormal fetal placental PI associated with a higher incidence of perinatal complications. Hence, the finding of abnormal PI must induce the physician to carry out more intensive obstetric care of women with GDM.
Fadda
G M
GM
Department of Pharmacology, Gynecology and Obstetrics, University of Sassari, Sassari, Italy.
D'Antona
D
D
Ambrosini
G
G
Cherchi
P L
PL
Nardelli
G B
GB
Capobianco
G
G
Dessole
S
S
D000328:Adult; D001013:Aorta, Thoracic / Q000502:physiology; D001783:Blood Flow Velocity; D002536:Cerebral Arteries / Q000502:physiology; D036861:Delivery, Obstetric; D016640:Diabetes, Gestational / Q000150:complications / Q000503:physiopathology*; D005260:Female; D005315:Fetal Diseases / Q000209:etiology*; D005333:Fetus / Q000098:blood supply*; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D007902:Length of Stay; D010920:Placenta / Q000098:blood supply*; D011247:Pregnancy; D011673:Pulsatile Flow; D014469:Umbilical Arteries / Q000502:physiology