title: Stable fetal hemodynamics measured by Doppler flow after initiation of anti-hypertensive treatment with methyldopa in pregnant women with diabetes.
abstract: OBJECTIVE
  To evaluate whether initiation of anti-hypertensive treatment with methyldopa affects fetal hemodynamics in women with pregestational diabetes.
  
  
  METHODS
  Prospective study of unselected singleton pregnant women with diabetes (seven type 1 and two type 2 diabetes), normal blood pressure and kidney function at pregnancy booking. Methyldopa treatment was initiated at blood pressure >135/85 mmHg and/or urinary albumin excretion (UAE) >300 mg/g creatinine. Pulsatility indices (PI) of the uterine, umbilical, middle cerebral arteries before and 1 week after initiation of methyldopa treatment (250 mg three times daily) was performed and the cerebro-placental ratio (CPR) was calculated.
  
  
  RESULTS
  Methyldopa treatment was initiated at median 249 (range 192-260) gestational days, mainly due to gestational hypertension (n = 7). Blood pressure declined from 142 (112-156)/92 (76-103) mmHg before to 129 (108-144)/82 (75-90) mmHg after initiation of methyldopa treatment (p = 0.11 and 0.04 for systolic and diastolic blood pressure, respectively). There were no significant changes in the umbilical artery PI (0.82 (0.72-1.40) versus 0.87 (0.64-0.95), p = 0.62) or CPR (1.94 (0.96-2.33) versus 1.78 (1.44-2.76), (p = 0.73). Gestational age was 265 (240-270) d. Apgar scores were normal.
  
  
  CONCLUSIONS
  Stable Doppler flow velocity waveforms were documented after initiation of methyldopa treatment for pregnancy-induced hypertensive disorders in this cohort of pregnant women with pregestational diabetes.
authors: a Center for Pregnant Women with Diabetes, University of Copenhagen , Copenhagen , Denmark .|b Department of Obstetrics .
authors: Berit Woetmann
authors: BW
authors: Pedersen
authors: a Center for Pregnant Women with Diabetes, University of Copenhagen , Copenhagen , Denmark .|c Department of Endocrinology , University of Copenhagen , Copenhagen , Denmark .
authors: Lene
authors: L
authors: Ringholm
authors: a Center for Pregnant Women with Diabetes, University of Copenhagen , Copenhagen , Denmark .|b Department of Obstetrics .|d Faculty of Health and Medical Sciences , The Institute of Clinical Medicine, University of Copenhagen , Copenhagen , Denmark , and.
authors: Peter
authors: P
authors: Damm
authors: b Department of Obstetrics .|d Faculty of Health and Medical Sciences , The Institute of Clinical Medicine, University of Copenhagen , Copenhagen , Denmark , and.|e Department of Obstetrics , Center for Fetal Medicine , Copenhagen , Denmark.
authors: Ann
authors: A
authors: Tabor
authors: b Department of Obstetrics .|e Department of Obstetrics , Center for Fetal Medicine , Copenhagen , Denmark.
authors: Kirsten
authors: K
authors: Søgaard
authors: a Center for Pregnant Women with Diabetes, University of Copenhagen , Copenhagen , Denmark .|b Department of Obstetrics .
authors: Ellinor
authors: E
authors: Hellmuth
authors: a Center for Pregnant Women with Diabetes, University of Copenhagen , Copenhagen , Denmark .|c Department of Endocrinology , University of Copenhagen , Copenhagen , Denmark .|d Faculty of Health and Medical Sciences , The Institute of Clinical Medicine, University of Copenhagen , Copenhagen , Denmark , and.
authors: Elisabeth R
authors: ER
authors: Mathiesen
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001034:Apgar Score; D005260:Female; D005865:Gestational Age; D006439:Hemodynamics; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000188:drug therapy*; D008750:Methyldopa / Q000627:therapeutic use*; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging; D011247:Pregnancy; D011254:Pregnancy in Diabetics; D011446:Prospective Studies; D018617:Ultrasonography, Doppler, Pulsed; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging; D055988:Uterine Artery / Q000000981:diagnostic imaging
chemical_list: D000959:Antihypertensive Agents; D008750:Methyldopa
keywords: Fetal blood flow; hypertension; methyldopa; preeclampsia; pregnancy