Abstract
In order to determine the influence of maternal glycemic control on the fetal circulation, Doppler flow velocity waveforms (DFVWs) were obtained at 30, 33, and 36–40 weeks in 17 women with overt diabetes, 20 with gestational diabetes (GDM), and 14 low-risk pregnant women. DFVWs were obtained from the umbilical artery (UA), internal carotid artery (ICA), ascending aorta, and main pulmonary artery. The ICA resistance index was lower in GDM than controls (P = 0.014). As a result, the cerebral-umbilical Doppler ratio (ICA resistance index/UA resistance index) was lower in GDM than controls (P = 0.031). There was a significant correlation between either the mean daily glycemia (r = 0.54, P < 0.01) or the mean daily M-value, an index of glucose excursion and mean glycemia (r = 0.61, P< 0.001), and the cerebral-umbilical Doppler ratio. As the maternal glycemic control became tighter, the fetal cerebral-umbilical Doppler ratio decreased to values similar to the “brain-sparing” effect described in growth-retarded ...
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