The Value of Fetal Cerebro-umbilical Doppler Indices in Predicting Umbilical Blood Gas Abnormalities and Apgar Score in Diabetic Pregnant Women

Abstract

Aim:There is conflicting data regarding the utility of Doppler indices in patients with diabetes. Our objective was to investigate the value of fetal Doppler parameters on umbilical blood gas abnormalities and Apgar scores in term diabetic pregnancies treated with insulin.Methods:A total of 120 pregnant women with pregestational or gestational diabetes underwent Doppler screening between 37 and 38 weeks of gestation. The main outcome was to compare the diagnostic performance of the umbilical artery-pulsatility index (UA-PI), middle cerebral artery-PI (MCA-PI), cerebroplacental ratio (CPR), and umbilicocerebral ratio (UCR) in detecting the presence of intrauterine hypoxemia.Results:From the sample, 18 (15%) had type 1 diabetes mellitus (DM), 40 (33.3%) had type 2 DM, and 62 (51.7%) had GDM A2. The median gestational age at the time of Doppler screening was 37 weeks and 3 days (range 37 weeks to 38 weeks 2 days) and the mean ± standard deviation gestational age at delivery was 38 weeks 4 days ± 3 days. No significant correlations were observed for MCA-PI, UA-PI, CPR, or UCR with any of the measured outcomes. Analysis of Doppler parameters of normal neonates and those with abnormal composite tests showed that Doppler parameters were non-significant in predicting abnormal composite outcomes.Conclusion:The data obtained from this study show that the low predictive ability of Doppler velocimetry in abnormal neonatal tests results in pregnancies complicated by diabetes.

Keywords

• diabetes mellitus
• fetal doppler
• fetal hypoxia
• pregnancy
• pulsatility index