Gynecology & Obstetrics
Open Access
ISSN: 2161-0932
ISSN: 2161-0932
Anna Lund Rasmussen and Finn Friis Lauszus
This study was designed to test umbilical indices and establish a reference in pregnancies complicated by type 1 diabetes mellitus, and to correlate the pulsatility index to other clinical parameters. We included consecutively 129 type 1 diabetic pregnant women during a five year period. During their pregnancy HbA1c, electrolytes, uric acid, diurnal blood pressure was measured and 24-h urine collected for measurement of albumin excretion rate. Umbilical blood flow measurements were done routinely from week 32 and started before week 32 on indication. Resistance and pulsatility indices and systolic-diastolic ratio were measured. The weekly repeated measurements from gestational 32 to 34 had the lowest levels of pulsatility index in the normoalbuminuria group and highest in the micro- and macroalbuminuria group combined (p = 0.01). We found an association of pulsatility index and umbilical pH (p<0.006). Even when adjusted for birth weight ratio, blood pressure, albumin excretion rate and HbA1c the association of pulsatility index and umbilical pH persisted (r = -0.30, p = 0.016). Glycemia expressed as HbA1c was associated with pulsatility index at nearly all measurements from week 31 to 35 and associated with albumin excretion rate. We were not able to predict adverse feto-maternal outcome in our pregnancies using umbilical indices. The correlation of pulsatility index and HbA1c underlines the importance of glycemic status during pregnancy. Albumin excretion rate affects the level of the umbilical pulsatility index.