A Random Single Doppler Study of the Umbilical Artery in the Evaluation of Pregnancies Complicated by Diabetes

Abstract

To evaluate a random single Doppler study of the systolic to diastolic ratio of the umbilical artery as a predictor of perinatal outcome in diabetic pregnancies, a prospective double-blind study was performed in 92 diabetic pregnant women between 28 and 40 weeks of gestation. Main outcome measures were perinatal outcome: group A, normal outcome; group B, poor outcome. The sensitivity and specificity of the Doppler studies as a predictor of poor perinatal outcome were 39% and 92%, respectively. The positive and negative predictive values were 54% and 86%, respectively. Our results suggest that the systolic to diastolic ratio of the umbilical artery offers no advantage over other well-established tests in the management of diabetic pregnancies.

Use of umbilical artery Doppler velocimetry in the monitoring of pregnancy in women with pre‐existing diabetes

“…The conflicting evidence from previous publications may be due to two confounding factors. First, several of the studies included a large number of pregnancies with gestational diabetes 3,4,9,12 . Perinatal morbidity and mortality is much lower in women with gestational diabetes mellitus.…”

“…found that an abnormal umbilical artery resistance index was a significant predictor of fetal compromise in diabetic pregnancies, although fetal compromise could also occur in association with a normal resistance index 2 . However, others have failed to demonstrate any usefulness of umbilical artery Doppler velocimetry in the monitoring of diabetic pregnancies 7–9 …”

Vitalidade Fetal em Gestações Complicadas com Diabete Melito Pré-Gestacional: Um Estudo Longitudinal

“…A avaliação da dopplervelocimetria da arté-ria umbilical em gestantes diabéticas não têm demonstrado associação da doença com anormalidades da circulação placentária ou fetal 9,21 . Porém, quando ocorre associação com outras anormalidades tais como a hipertensão ou a vasculopatia, esta técnica tem papel fundamental na avaliação da função placentária 22,23 .…”

Applications of Doppler Studies for Fetal Surveillance in Diabetic Pregnancies

“…The positive and negative predictive values were 54% and 86% respectively. The authors suggested that the systolic/diastolic ratio of the umbilical artery offer no advantage over other well established tests in management of diabetic pregnancies (Ben-Ami et al, 1995). In a cohort of 104 women with both type I and type II pre-existing diabetes mellitus, umbilical artery Doppler was performed at 28, 32, 36 and 38 weeks gestation.…”