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

Autor: Kutuk MS; Department of Obstetrics and Gynecology, Bezmialem Vakif University, Istanbul, Turkey., Dolanbay M; Department of Obstetrics and Gynecology, Erciyes University, Kayseri, Turkey., Gokmen Karasu AF; Department of Obstetrics and Gynecology, Bezmialem Vakif University, Istanbul, Turkey., Ozgun MT; Department of Obstetrics and Gynecology, Erciyes University, Kayseri, Turkey.
Jazyk: angličtina
Zdroj: Journal of clinical ultrasound : JCU [J Clin Ultrasound] 2018 Jul; Vol. 46 (6), pp. 391-396. Date of Electronic Publication: 2018 Mar 26.
DOI: 10.1002/jcu.22593
Abstrakt: Purpose: 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.
Methods: 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.
Results: A total of 120 cases were included in the final analysis. The median (Q 1 - Q 3 ) 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 (Q 1 -Q 3 ) 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.
Conclusion: 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.
(© 2018 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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