Ductus venosus blood flow velocity waveform in diabetic pregnancies.
OBJECTIVE
Maternal diabetes during pregnancy is associated with congenital cardiac malformations and hypertrophic cardiomyopathy. Blood flow in the ductus venosus (DV) has been postulated to reflect cardiac function. The aim of our study was to investigate if diabetic pregnancies exhibit abnormal DV hemodynamics, hence indicating changes in fetal cardiac function.


METHODS
The pulsatility index of the DV (DV-PI) was analyzed retrospectively in 142 diabetic patients and compared to previously published DV-PI reference values from a non-diabetic low-risk population. DV values were then correlated with maternal glycosylated hemoglobin (HbA1c).


RESULTS
DV-PI was significantly higher in pregnancies complicated by either pre-existing insulin-dependent (DM) or gestational diabetes when compared with normal reference values. Increased DV-PI values were still evident in both diabetic groups when neonates that were small-for-gestational age and neonates with pathological umbilical blood flow pattern were excluded from the analysis. In DM pregnancies a statistically significant correlation was found between DV-PI and maternal HbA1c.


CONCLUSIONS
Diabetic pregnancies exhibit increased DV-PI values when compared to a normal low-risk pregnant population, possibly indicating a fetal cardiac effect.
Stuart
A
A
Department of Obstetrics and Gynecology, Central Hospital, Helsingborg, Sweden. stuart.andrea@gmail.com
Amer-Wåhlin
I
I
Gudmundsson
S
S
Marsál
K
K
Thuring
A
A
Källen
K
K
D000328:Adult; D001724:Birth Weight / Q000502:physiology; D001783:Blood Flow Velocity / Q000502:physiology; D005260:Female; D005865:Gestational Age; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011673:Pulsatile Flow / Q000502:physiology*; D012016:Reference Values; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000098:blood supply* / Q000000981:diagnostic imaging
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human