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Doppler umbilical artery flow velocity waveforms in diabetic pregnancy
F D Johnstone1, J M Steel, N G Haddad
1Department of Obstetrics and Gynaecology, Simpson Memorial Maternity Pavilion and Edinburgh Royal Infirmary, UK.
British Journal of Obstetrics and Gynaecology
|February 1, 1992
Summary
In diabetic pregnancies, umbilical artery resistance index (RI) is a significant predictor of fetal compromise. However, normal RI values do not rule out fetal compromise, so undue reliance should not be placed on these findings.
Area of Science:
- Maternal-Fetal Medicine
- Obstetrics
- Fetal Monitoring
Background:
- Diabetes mellitus in pregnancy can impact fetal well-being.
- Umbilical artery flow velocity waveforms (FVWs) are used to assess fetal status.
- The relationship between glycemic control, FVWs, and fetal compromise in diabetes requires further investigation.
Purpose of the Study:
- To evaluate the effect of uncomplicated diabetes on umbilical artery FVWs.
- To determine the correlation between glycemic control and FVWs.
- To assess the predictive value of umbilical artery FVWs for antenatal fetal compromise.
Main Methods:
- Prospective descriptive study involving 128 pregnancies with diabetes and 170 controls.
- Umbilical artery resistance index (RI) and glycosylated hemoglobin measured bi-weekly from 28 weeks in diabetic pregnancies.
- Antenatal fetal compromise defined by cardiotocography and biophysical profile score.
Main Results:
- Uncomplicated diabetic pregnancies exhibited normal umbilical artery FVW values, similar to non-diabetic controls.
- Glycemic control showed no significant relationship with umbilical artery FVW values.
- Abnormal umbilical artery RI predicted fetal compromise and lower birthweights, but fetal compromise also occurred with normal RI.
Conclusions:
- The non-diabetic range of umbilical artery RI is appropriate for pregnancies with diabetes.
- Long-term glycemic control within the study's range did not affect umbilical artery RI.
- Abnormal umbilical artery RI is a significant predictor of fetal compromise, but normal RI does not exclude it; thus, normal FVWs should not be solely relied upon.
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