Abstract
This study aimed to investigate whether the third trimester fetal cardiac diastolic function measured by selected conventional Doppler indices is affected in appropriate-for-gestational-age or macrosomic fetuses of gestational diabetic mothers with poor glycaemic control. This cross-sectional study included 93 pregnant women divided into two groups. Group 1 included 45 appropriate-for-gestational-age or macrosomic fetuses from gestational diabetic mothers with poor glycaemic control (study group). Group 2 included 48 appropriate-for-gestational-age fetuses from gestational age-matched healthy mothers (control group). Functional fetal cardiac parameters and fetoplacental Doppler parameters were measured. Data were compared between the two groups. Maternal characteristics did not differ significantly between the study and the control group. There were no significant differences in the early and late velocity, early/late velocity ratio of both mitral and tricuspid valves, the fetal pulmonary vein pulsatility index, and the ductus venosus pulsatility index between the study and the control group. Moreover, the rate of abnormal Doppler findings in pulmonary vein (pulmonary vein pulsatility index >95th centile), ductus venosus (ductus venosus pulsatility index >95th centile), and peripheral vessels (umbilical artery pulsatility index >95th centile, middle cerebral artery pulsatility index <5th centile, cerebra-placental index >95th centile) were comparable in both groups. The third trimester fetal diastolic functions measured by selected conventional Doppler techniques do not seem to be altered in appropriate-for-gestational-age or macrosomic fetuses of gestational diabetic mothers who have poor glycaemic control.
Highlights
Gestational diabetes mellitus is the most common metabolic disorder in pregnancy
This study aims to investigate whether fetal cardiac diastolic functions measured by selected conventional Doppler indices are altered in appropriate-for-gestational-age or macrosomic fetuses of gestational diabetic mothers with poor glycaemic control
A total of 45 appropriate-for-gestational-age or macrosomic fetuses with poorly controlled gestational diabetes mellitus were matched by gestational age and maternal age to 47 controls
Summary
Fetal biometric measurements, including biparietal diameter, head circumference, abdominal circumference, and femur length, were obtained for each fetus to determine the fetal growth and estimated fetal weight (Hadlock formula; biparietal diameter, head circumference, abdominal circumference, femur length).[19] Fetoplacental circulation was assessed with the Doppler measurements including, middle cerebral artery pulsatility index, umblical artery pulsatility index, ductus venosus pulsatility index, and cerebra-placental index. Middle cerebral artery Doppler measurements were obtained through an axial view of the fetal cranium, including the thalamus and sphenoid bone wings. In this plane, the spectral Doppler gate is placed immediately after the origin of the middle cerebral artery.
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