Abstract
to study the relation between amniotic fluid volume and glycemic control in pregnancies complicated by diabetes mellitus type 1 and 2, followed in a specialized multidisciplinary prenatal care service. This descriptive study was performed between January 2001 and December 2004. Inclusion criteria were: simple pregnancy, diagnosis of pregestational diabetes, beginning of prenatal care before the 26th week and absence of fetal anomaly. Cases with newborns small for gestational age were excluded. The amniotic fluid index (AFI) was measured weekly, beginning at the 27th week of gestation and continued until delivery and the maternal glycemic profile was obtained a week before ultrasound assessment. This profile consisted of the glycemic level averages and percentages of the abnormal high values. Correlation between the glycemic profile and the AFI was shown by the Spearman correlation test. Sixty pregnant women were assessed and 659 correlations between the AFI and glycemic profile were obtained. No correlation was observed in any of the gestational weeks studied. The mean glycemic value was 103.69 mg/dl (SD=13.69) in the group with AFI pound18 cm, and the 103.67 mg/dl (SD=11.46) in the group with AFI < 18 cm and no significant difference was detected. This study showed no correlation between AFI and maternal glycemic profile during the third trimester in type 1 and 2 diabetic pregnant women, undergoing standardized treatment and rigorous metabolic control.
Highlights
O Diabetes mellitus é a síndrome metabólica de maior prevalência mundial
BACKGROUND. to study the relation between amniotic fluid volume and glycemic control in pregnancies complicated by diabetes mellitus type 1 and 2, followed in a specialized multidisciplinary prenatal care service
The amniotic fluid index (AFI) was measured weekly, beginning at the 27th week of gestation and continued until delivery and the maternal glycemic profile was obtained a week before ultrasound assessment
Summary
Sete dias que antecederam a avaliação ultrassonográfica). Cada gestante contribuiu com 11 correlações, em média. Quando o Diabetes mellitus está presente desde o início da gravidez, estados hiperglicêmicos no primeiro e no segundo trimestre promovem alterações na programação da placenta com alterações no perfil das proteínas transportadoras de glicose (GLUTs), que passam a se expressar de forma diversa nessas placentas.[23, 24] Dessa forma, qualquer elevação nos níveis glicêmicos dessas gestantes, no terceiro trimestre, favorece maior transporte da glicose para a circulação fetal. Entretanto, neste estudo, as gestantes diabéticas pré-gestacionais seguidas em ambulatório especializado com controle glicêmico rigoroso não reproduziram o modelo teórico da relação entre a glicemia materna e a avaliação ultrassonográfica. Dessa forma, o presente estudo não encontrou correlação entre o ILA e o perfil glicêmico avaliado na semana anterior à realização do exame ultrassonográfico em gestantes diabéticas pré-gestacionais em tratamento. BACKGROUND. to study the relation between amniotic fluid volume and glycemic control in pregnancies complicated by diabetes mellitus type 1 and 2, followed in a specialized multidisciplinary prenatal care service
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