Correlation of Ultrasonographic and Pathophysiologic Measurements of Umbilical Vessels in Gestational Diabetes

Abstract

Aims: In diabetic pregnancies, the resistance of placental blood vessels might be increased, which can affect uteroplacental blood flow and have influence on the oxygen and nutrient supply of fetus and on fetal growth. Our aim was to compare the ultrasonographic, pathomorphologic data and vasoreactivity of umbilical and placental vessels of gestational diabetic newborns to that of the normal pregnancies. Methods: In this case-control study the placental vascularization of pregnant women was determined by 3D power Doppler ultrasound technique. We calculated the vascularization index, flow index and vascularization flow index. We performed tissue bath experiment (treatment with oxytocin and desmopressin) on umbilical vessels and collected pathomorphologic data according to the Royal College of Pathologists’ 2011 protocol. Results: The placental vascularization index and the umbilical artery S/D were significantly lower in the case group. If all placental indices are low during pregnancy, then the odds of the pathological vascular tone in umbilical cord is significantly high. In isolated tissue bath experiment, oxytocin and desmopressin did not elicit significant contraction on umbilical cord vessels. Conclusions: Our results suggest that umbilical vessels might have different receptor pathway regulation that can compensate the rheological changes in the pregnant’s blood flow and gives opportunity for selective therapy to fetuses more vulnerable to hypoxia.

Keywords

• gestational diabetes
• 3D Power Dopple
• 3D power doppler
• histopathology
• umbilical cord