Doppler study of the umbilical and fetal middle cerebral arteries in women with gestational diabetes mellitus.

OBJECTIVE

To investigate the correlation between Doppler parameters in the umbilical and fetal middle cerebral arteries and pregnancy outcome in women with gestational diabetes mellitus (GDM).

METHODS

A prospective study was performed on 169 singleton GDM pregnancies in a university teaching hospital from January to December 2002. Umbilical artery (UA) pulsatility index (PI) and middle cerebral artery (MCA) PI and peak systolic velocity (Vmax) were measured every 4 weeks until delivery from the time of diagnosis of GDM. The pregnancy outcome was obtained from the hospital database. Using linear or quadratic regression, lines of best fit were drawn to compare the Doppler measurements between the two groups with normal and abnormal pregnancy outcomes.

RESULTS

One hundred and thirty-eight women with known pregnancy outcome completed the study. A total of 305 Doppler examinations were performed with one to four examinations for each woman. Thirty-eight women (27.5%) had one or more abnormal pregnancy outcomes: placental abruption, pre-eclampsia, preterm delivery, small-for-gestational age (SGA) infants, low Apgar scores, neonatal jaundice requiring treatment, sepsis, birth trauma, meconium aspiration syndrome, respiratory and neurological complications. There was extensive overlap of the UA-PI, MCA-PI and MCA-Vmax measurements between the two groups.

CONCLUSION

A Doppler study of the UA-PI, MCA-PI and MCA-Vmax was not useful in the prediction of abnormal pregnancy outcome in GDM.