Fetal cerebral hemodynamic in gestational diabetic versus normal pregnancies: a Doppler velocimetry of middle cerebral and umbilical arteries

Zanjani, Mansoureh Shabani; Nasirzadeh, Roya; Fereshtehnejad, Seyed‐Mohammad; Asl, Ladan Yoonesi; Alemzadeh, Sayyed Amirpooya; Askari, S N

doi:10.1007/s13760-013-0221-7

Cited by 19 publications

(23 citation statements)

References 32 publications

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“…In the present study, no statistically significant between‐group difference was found for Doppler ultrasonographic scans of the UA‐PI. This finding was in line with the published literature, which suggested that Doppler ultrasonographic evaluation of the umbilical artery is probably not a good parameter for assessing fetal wellbeing in the presence of GDM . Changes in Doppler parameters for the umbilical artery would be expected given the abnormalities previously described in the structure of the placental blood vessels associated with GDM .…”

Section: Discussionsupporting

confidence: 89%

“…This finding was in line with the published literature, which suggested that Doppler ultrasonographic evaluation of the umbilical artery is probably not a good parameter for assessing fetal wellbeing in the presence of GDM. [21][22][23] Changes in Doppler parameters for the umbilical artery would be expected given the abnormalities previously described in the structure of the placental blood vessels associated with GDM. 24 The surface area on the edge of the tertiary chorionic villi and the diffusion distance between the maternal and fetal blood flow are both increased.…”

Section: Discussionmentioning

confidence: 99%

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Doppler ultrasonographic assessment of fetal middle cerebral artery peak systolic velocity in gestational diabetes mellitus

Dantas

Palmieri

Vieira

et al. 2018

Intl J Gynecology & Obste

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Objective To compare Doppler ultrasonographic measurements of the fetal middle cerebral artery peak systolic velocity (MCA PSV) among women with or without gestational diabetes mellitus (GDM). Methods A cross‐sectional study was conducted among pregnant women who presented for prenatal care at a single hospital in Brazil between September 11, 2015, and January 6, 2017. Patients were stratified into a group with GDM and a control group without GDM. One Doppler ultrasonographic assessment was performed per participant. This measurement was made after diagnosis but before the start of treatment among women in the GDM group. Fetal ultrasonographic and biometric variables assessed included MCA PSV, MCA pulsatility index, umbilical artery pulsatility index, the MCA–to‐umbilical artery ratio, abdominal circumference, and weight. Results The study included 238 women: 115 in the GDM group and 123 in the control group. The median MCA PSV was 1.02 in the GDM group and 1.08 in the control group (P=0.036). No statistically significant between‐group differences were found for the other fetal ultrasonographic variables or for the fetal biometric variables assessed. None of the maternal or fetal parameters assessed displayed a linear correlation with MCA PSV. Conclusion Doppler ultrasonographic measurements of MCA PSV were lowered among the fetuses of women diagnosed with GDM.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Doppler ultrasonographic assessment of fetal middle cerebral artery peak systolic velocity in gestational diabetes mellitus

Dantas

Palmieri

Vieira

et al. 2018

Intl J Gynecology & Obste

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show abstract

“…This finding was not in harmony with the results reported in a study by Salvesen (9), which showed that maternal DM is not associated with abnormalities in Doppler indices of placental or fetal circulation. Nevertheless, the current results were in accordance with a previous study which showed higher values in women with GDM, compared to their normal counterparts (12).…”

Section: Discussionsupporting

confidence: 93%

“…The sample size was determined to be 100 cases, based on a study by Shabani, in which the mean MCA in gestational diabetes was 2.1 ± 0.4 (with a significance level of 95%, precision of 0.08 from standard deviation, and power of 80%), and the formula used for estimating the mean value in a target population (12).…”

Section: Sample Collectionmentioning

confidence: 99%

Comparison of Umbilical Arterial Doppler and Middle Cerebral Arterial Doppler Assessments of Fetal Well-being in Mothers with Diabetes Mellitus: A Prospective Study

Niromanesh

Shirazi

Eftekhariyazdi

et al. 2016

Iran Red Crescent Med J

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Background: Diabetes mellitus may accompany and complicate a pregnancy, resulting in poor neonatal outcomes. Objectives: The aim of this study was to compare middle cerebral arterial (MCA) and umbilical arterial (UA) Doppler assessments for the evaluation of fetal well-being in mothers with pre-gestational or gestational diabetes mellitus. Methods: This cohort study was performed on 103 pregnant diabetic women, admitted for prenatal care to the department of gynecology and obstetrics of Jame Zanan hospital (Tehran, Iran) in 2015. Sampling was performed, using the convenience method. All women underwent one or more Doppler ultrasound examinations in the third trimester of pregnancy, which included blood flow measurement through umbilical and middle cerebral arteries. Women with abnormal UA or MCA Doppler test results were subjected to labor induction or cesarean section, according to different parameters. The outcomes included neonatal acidosis, oneand five-min Apgar scores, hypoglycemia, hypocalcaemia, neonatal intensive care unit (NICU) admission, gestational age at delivery, and neonatal death. Chi-square test, t-test or Fisher's exact test, and logistic regression analysis were performed to analyze the data. Results: Based on the findings, poor outcomes were detected in 48 women. Nearly 17.5% and 9.7% of women had abnormal UA and MCA Doppler test results, respectively. In total, 62% of women gave birth via cesarean section. The UA Doppler test results were significantly related with hypoglycemia, respiratory distress syndrome (RDS), one-min Apgar score < 7, five-min Apgar score < 7, and NICU admission, while the MCA Doppler results were significantly associated with RDS and neonatal death (P < 0.05). The sensitivity of both tests ranged between 20% and 60%. Logistic regression analysis revealed that UA Doppler test could predict poor outcomes after fasting blood sugar control (P = 0.028, OR = 3.6, CI: 1.15 -11.13). Conclusions: Both UA and MCA Doppler tests were associated with some neonatal outcomes. However, sensitivity of both UA and MCA assessments was low in the prediction of adverse neonatal outcomes. By the comparison of these two methods, we found that UA Doppler assessment is a better predictor of neonatal outcomes.

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“…Resistance is reduced and brain development is promoted, so reflecting the contribution of the MCA to HC. [1920] Meanwhile, the RA, which is extremely sensitive to hypoxia and ischemia, tends to contract to redistribute blood flow. Therefore, the S/D, PI, and RI of RA are prone to increasing in order to ensuring the blood supply to major organs of the fetus, such as the brain and liver.…”

Section: Discussionmentioning

confidence: 99%

Fetal Hemodynamics and Fetal Growth Indices by Ultrasound in Late Pregnancy and Birth Weight in Gestational Diabetes Mellitus

Liu

Lai

et al. 2016

Chinese Medical Journal

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Background:The offspring of women with gestational diabetes mellitus (GDM) are prone to macrosomia. However, birth weight is difficult to be correctly estimated by ultrasound because of fetal asymmetric growth characteristics. This study aimed to investigate the correlations between fetal hemodynamics, fetal growth indices in late pregnancy, and birth weight in GDM.Methods:A total of 147 women with GDM and 124 normal controls (NC) were enrolled in this study. Fetal hemodynamic indices, including the systolic/diastolic ratio (S/D), resistance index (RI), pulsatility index (PI) of umbilical artery (UA), middle cerebral artery (MCA), and renal artery (RA), were collected. Fetal growth indices, including biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length, were also measured by ultrasound. Birth weight, newborn gender, and maternal clinical data were collected.Results:The independent samples t-test showed that BPD, HC, and AC were larger in GDM than in NC (P < 0.05). Fetal hemodynamic indices of the UA and MCA were lower (P < 0.05), but those of the RA were higher (P < 0.001) in GDM than in NC. Birth weight was higher in GDM than in NC (P < 0.001). Pearson's correlation analysis showed that hemodynamic indices of the UA were negatively correlated with birth weight, BPD, HC, and AC in both groups (P < 0.05). MCA (S/D, PI, and RI) was negatively correlated with birth weight, HC, and AC in GDM (r = −0.164, −0.206, −0.200, −0.226, −0.189, −0.179, −0.196, −0.177, and − 0.172, respectively, P < 0.05), but there were no correlations in NC (P > 0.05). RA (S/D, PI, and RI) was positively correlated with birth weight in GDM (r = 0.168, 0.207, and 0.184, respectively, P < 0.05), but there were no correlations in NC (P > 0.05).Conclusion:Fetal hemodynamic indices in late pregnancy might be helpful for estimating newborn birth weight in women with GDM.

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Fetal cerebral hemodynamic in gestational diabetic versus normal pregnancies: a Doppler velocimetry of middle cerebral and umbilical arteries

Cited by 19 publications

References 32 publications

Doppler ultrasonographic assessment of fetal middle cerebral artery peak systolic velocity in gestational diabetes mellitus

Doppler ultrasonographic assessment of fetal middle cerebral artery peak systolic velocity in gestational diabetes mellitus

Comparison of Umbilical Arterial Doppler and Middle Cerebral Arterial Doppler Assessments of Fetal Well-being in Mothers with Diabetes Mellitus: A Prospective Study

Fetal Hemodynamics and Fetal Growth Indices by Ultrasound in Late Pregnancy and Birth Weight in Gestational Diabetes Mellitus

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