Placental Doppler velocimetry in gestational diabetes mellitus.
OBJECTIVE
To evaluate if maternal glucose level and growth of the fetus were related to placental vascular impedance in pregnancy complicated by gestational diabetes mellitus.


METHODS
A retrospective study of 146 gestational diabetic women of which 117 needed insulin therapy. Glycosylated hemoglobin (HbA1c) was evaluated as well as umbilical and uterine artery Doppler velocimetry. The results were related to adverse outcome of pregnancy including newborn birthweight.


RESULTS
Abnormal umbilical artery blood flow velocity was seen in 5% of the cases and abnormal uterine artery flow in 16%. Uterine and umbilical artery vascular impedance was significantly lower in macrosomic newborns. There was a poor correlation between HbA1c, vascular impedance and birthweight. There were 11 cases that developed preeclampsia, all having abnormal uterine artery Doppler and two abnormal umbilical artery Doppler.


CONCLUSIONS
Uterine and umbilical artery vascular impedance in pregnancies complicated by gestational diabetes is related to birthweight and placental weight, but not to maternal HbA1c levels. Placental Doppler ultrasound does not seem to be of clinical value for fetal surveillance in these pregnancies unless the pregnancy is complicated by preeclampsia and/or intrauterine fetal growth restriction.
Pietryga
Marek
M
Karol Marcinkowski University of Medical Sciences, Poznan, Poland.
Brazert
Jacek
J
Wender-Ozegowska
Ewa
E
Dubiel
Mariusz
M
Gudmundsson
Saemundur
S
D001786:Blood Glucose / Q000378:metabolism*; D016640:Diabetes, Gestational / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D006801:Humans; D010920:Placenta / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011247:Pregnancy; D012189:Retrospective Studies; D018617:Ultrasonography, Doppler, Pulsed
D001786:Blood Glucose