Journal of Ultrasound in Medicine, Vol 15, Issue 6 437-440, Copyright © 1996 by American Institute of Ultrasound in Medicine
Is there a correlation between aortic Doppler velocimetric findings in diabetic pregnant women and fetal outcome?
E. A. Reece, Z. Hagay, W. Moroder, N. DeGennaro, C. Homko and A. Wiznitzer
Department of Obstetrics, Gynecology, and Reproductive Sciences, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
At present, the role of Doppler velocimetry in monitoring fetal well-being
in diabetic pregnancies is controversial. The present study was conducted
to determine if fetal aortic velocity waveforms were correlated with fetal
outcome in pregnancies complicated by diabetes mellitus. Fetal aortic blood
flow was prospectively assessed in 30 pregnant women with insulin-dependent
diabetes mellitus. Systolic-diastolic ratios were obtained at 2 week
intervals between 18 and 38 weeks of gestation. They were analyzed
according to several fetal outcome variables. Infants with presumed fetal
distress during labor and neonates with respiratory abnormalities
(respiratory distress syndrome, persistent fetal circulation, or transient
tachypnea of the newborn) showed statistically significant elevations of
aortic Doppler indices (P < 0.031 and < 0.011, respectively).
However, these correlations lacked clinical relevance. The infants
demonstrated no evidence of fetal distress at birth since Apgar scores were
> 7 at 5 min in all but one neonate. No relationship was found between
the mean third trimester fetal aortic systolic-diastolic ratios and
perinatal death, preterm deliveries, birth weight, Apgar scores at 1 and 5
min, and neonatal metabolic abnormalities. These data demonstrate a poor
correlation between fetal aortic Doppler waveform analysis and fetal
outcome. Therefore, fetal aortic Doppler velocimetry cannot be used as a
means of assessing impending fetal compromise in offspring of diabetic
mothers.
