OGO 6351 Umbilical and uterine artery velocimetry and outcome of pregnancies complicated by insulin-dependent diabetes mellitus
✍ Scribed by R. Jaffe; J.C. Glantz; P. Eggers; D. Smith
- Publisher
- Elsevier Science
- Year
- 1997
- Tongue
- English
- Weight
- 135 KB
- Volume
- 23
- Category
- Article
- ISSN
- 0301-5629
No coin nor oath required. For personal study only.
✦ Synopsis
OBJECTIVE: To assess the relationship between longitudinal umbilical and uterine artery flow velocity waveform (FVW) analyses and maternal and fetal complicafions in diabetic pregnancies. STUDY DESIGN: Twenty-six pregnancies complicated by insulin-dependent diabetes mellitos were followed longitudinally from fast trimester to delivery. We measured uterine artery (UtA) resistance index (RQ, umbilical artery (UmbA) S/D, and HgbAlc q4wks. Blood glucose (BG) levels were. recorded q.1.d. We calculated RI and S/D slopes for each pregnancy. Using regression and parametric comparison testing, fit and last RI & S/D values. and RI &S/D slopes were correlated with glycemic control (medians sod interquartile ranges). diabetic class, delivery mute, and adverse perinatal outcomes. RESULTS: Aggregate UtA RI and UmbA S/D slopes were negative when plotted against gestational age. as expected (pcO.0001). Low I-minute Apgzu score and increased risk of any perinatal complication correlated with lesser UtA slope @1.006), while macrosomiacorrelated with lesser UmbA slope @=.036). Glycemic control and diabetic class did not correlate with UtA RI or UmbA S/D slopes. Last UtA RI and UmbA S/D measurements correlated with HgbA Ic interquvtile range. @=.017). and last UtA RI values were higher with increasing frequency of post-praodial hypoglycemia (p=.OZ3). Birthweight and diabetic class strongly correlated with glycemic control (p1.008).
CONCLUSIONS:
Abnormal uterine and umbilical artery FVW slopes do not corr&te with diabetic class or glycemic control. but do cow&to with increased risk of adverse outcome.