Ductus venosus velocimetry in monitoring pregnancy in women with pregestational diabetes mellitus.
OBJECTIVE
The purpose of this research was to assess the ability of ductus venosus (DV) Doppler velocimetry to predict adverse perinatal outcome in pregnancies complicated by pre-existing diabetes mellitus.


METHODS
This was a prospective study conducted at a tertiary referral obstetric facility in Brisbane, Australia. The study group included women with pregestational diabetes mellitus who delivered in the hospital between 1 January 1995 and 31 December 2006. The DV Doppler index was defined as abnormal if the DV peak velocity index for veins (PVIV) was equal to or greater than the 95(th) percentile for gestation. Adverse perinatal outcome included one or more of the following criteria: small-for-gestational-age infant; Cesarean section for non-reassuring fetal status; fetal acidemia at delivery; a 1-min Apgar score of <or= 3; a 5-min Apgar score of < 7; hypoxic ischemic encephalopathy; and stillbirth or neonatal death. The maternal characteristics and perinatal outcomes of pregnancies with normal or abnormal DV Doppler indices were compared.


RESULTS
Eighty-two pregestational diabetic pregnancies were studied and an abnormal DV-PVIV was identified in 25 (30.5%). Adverse perinatal outcome was identified in eight of 25 (32.0%) pregnancies with an abnormal DV-PVIV compared to seven of 57 (12.3%) pregnancies with a normal DV-PVIV (P < 0.05). The sensitivity of the DV-PVIV in predicting adverse perinatal outcomes in pregestational diabetic pregnancies was 53.3%, the specificity was 74.6%, the positive predictive value was 32.0% and the negative predictive value was 87.7%.


CONCLUSIONS
It may be useful to include DV-PVIV in the antenatal screening of pregnancies complicated by pregestational diabetes.
Wong
S F
SF
Department of Maternal Fetal Medicine, University of Queensland, Mater Mothers' Hospital, South Brisbane, QLD, Australia. shellwong@hotmail.com
Petersen
S G
SG
Idris
N
N
Thomae
M
M
McIntyre
H D
HD
D000328:Adult; D001315:Australia / Q000453:epidemiology; D001783:Blood Flow Velocity / Q000502:physiology; D005260:Female; D018056:Hemorheology / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D018566:Pregnancy, High-Risk; D011446:Prospective Studies; D018615:Ultrasonography, Doppler, Color; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*