Fetal Arterial and Venous Doppler Parameters Based on Amniotic Fluid Volume and Glycemic Status

In this study, it was aimed to evaluate fetal arterial and venous Doppler parameters and to assess their association with adverse obstetric outcomes by focusing on the amniotic fluid volume and glycemic status of pregnant women.

A prospective study was conducted at a tertiary care center from August 2022 to July 2024, including 171 participants divided into four groups: control (normal amniotic fluid, n = 47), idiopathic polyhydramnios (n = 42), gestational diabetes mellitus (GDM) with polyhydramnios (n = 42), and GDM with normal amniotic fluid (n = 40). Doppler ultrasonography was performed to measure arterial parameters, including middle cerebral artery (MCA), umbilical artery (UA), and uterine artery (UtA), and venous parameters, including pulmonary vein (PV), inferior vena cava (IVC), and ductus venosus (DV). Composite adverse perinatal outcomes (CAPO) were analyzed.

MCA S/D ratio and pulsatility index (PI) were significantly elevated in both GDM groups (p < 0.001), while UA and UtA parameters showed no significant differences between the groups. Venous Doppler parameters, including PV, IVC, and DV, did not correlate significantly with CAPO. The hepatic vein S/D ratio demonstrated a borderline significant increase in the idiopathic polyhydramnios group (p = 0.041). Although certain adverse neonatal outcomes, such as transient tachypnea of the newborn (TTN) and neonatal hypoglycemia, were more frequently observed in the GDM groups, no significant association was found between Doppler parameters and CAPO.

Venous Doppler measurements demonstrated minimal utility in forecasting unfavorable neonatal outcomes, whereas MCA Doppler parameters showed modest discriminatory ability and may reflect altered fetal hemodynamics in GDM pregnancies; however, their clinical utility remains limited. These findings highlight the complexity of outcomes associated with polyhydramnios and underscore the need for larger prospective studies to improve risk prediction in high-risk pregnancies.