Relationship between fetal peak systolic velocity in Middle cerebral artery and umbilical blood gas values and hemoglobin levels in diabetic pregnant women.

Abstract

To assess the relationship between peak systolic velocity in the middle cerebral artery (MCA-PSV) and fetal hypoxia in diabetic pregnant women requiring insulin therapy. The data of diabetic pregnant women using insulin who were followed in our departments were reviewed retrospectively. The relationships between MCA-PSV and umbilical cord pO2, pCO2, base deficit, hemoglobin, and birth weight were analyzed. A total of 120 cases were included in the final analysis. The median (Q1 - Q3 ) gestational age at Doppler evaluation was 37 weeks 3 days (37-38 weeks and 2 days), and the mean ± SD gestational age at delivery was 38 weeks 4 days ± 3days. The mean ± SD hemoglobin A1c (HbA1c) level was 5.7% ± 1.0% and, median (Q1 -Q3 ) daily total insulin dose was 25 U (10U-48U). There was no statistically significant correlation between MCA-PSV and pH, PO2, PCO2, base deficit, Hb, and birth weight (Spearman correlation, r:-.001[P = .99], r:-.011[P = .90], r:-.052 [P = .51], r: .049[P = .59], r: .049 [P = .59], r: .030 [P = .75], respectively). Using binary logistic regression analysis, no independent factor for the prediction of fetal acidosis (venous pH < 7.23), and metabolic acidosis (base deficit >6.3 mmol/L) was detected. MCA-PSV is not a good indicator of fetal polycythemia or chronic hypoxia in fetuses of diabetic pregnant women. Fetal well-being should be monitored with other tools in these circumstances.