Doppler Sonography in Pregnancies Complicated with Pregestational Diabetes Mellitus

Abstract

Antepartum fetal surveillance constitutes an essential component of the standards of care in managing pregnancies complicated with pregestational diabetes mellitus. Fetal hyperglycemia is associated with increased oxidative metabolism, hypoxemia, and increased brain and renal perfusion without any significant changes in fetoplacental perfusion. Moreover, the relationship between abnormal umbilical arterial Doppler indices and the quality of glycemic control remains unproven; however, observational studies suggest significant diagnostic efficacy of the umbilical arterial Doppler method in diabetic pregnancies complicated with FGR or hypertension. Although there are no randomized trials specifically addressing this issue, existing evidence suggests that Doppler velocimetry of the umbilical artery may be beneficial for antepartum fetal surveillance in diabetic pregnancies in the presence of these complications. Such utilization should be integrated with the existing standards of practice.