Role of middle cerebral artery, umbilical artery resistance indices and middle cerebral artery to umbilical artery resistance index ratio in predicting unfavorable perinatal outcomes of normotensive and hypertensive diabetic pregnancies

Citation:
Fouda, U. M., M. A. M. ElKassem, S. M. Hefny, and A. T. Hashem, "Role of middle cerebral artery, umbilical artery resistance indices and middle cerebral artery to umbilical artery resistance index ratio in predicting unfavorable perinatal outcomes of normotensive and hypertensive diabetic pregnancies ", Life Science Journal, vol. 10, issue 3, pp. 2371-2377, 2013.

Abstract:

Objective: To evaluate the role of middle cerebral artery (MCA), umbilical artery (UA)resistance indices (RI) and middle cerebral artery / umbilical artery resistance index ratio(MCA/UA RI) in predicting unfavorable perinatal outcomes in pregnancies complicated with diabetes mellitus. Methods: This prospective study included 96 women divided into 4 groups. Group 1 included 23 pregnant patients with preexisting diabetes, group 2 included 22 patients with gestational diabetes, group 3 included 24 diabetic pregnancies associated with hypertension and group 4 was a control group which included 27 patients with uncomplicated pregnancies. The umbilical artery and middle cerebral artery resistance indices were measured weekly starting from the 34th till the 38th week of pregnancy. Results: Abnormal UA RI (≥ 95th centile) had 78.57% sensitivity in detecting adverse perinatal outcomes in group 3 compared with 16.67 % and 0% sensitivity in group 1 and group 2 respectively. Abnormal MCA RI (≤ 5th centile) had 50% sensitivity in detecting adverse perinatal outcomes in group 3 compared with 0% sensitivity in groups 1 and 2. Abnormal MCA/UA RI (< 1) had 71.43 % sensitivity in detecting adverse perinatal outcomes in group 3 compared with 0 % sensitivity in groups 1 and 2. Conclusion: The abnormal UA RI, MCA RI and MCA/UA RI may be useful parameters in predicting adverse perinatal outcomes in diabetic pregnancies associated with hypertension. On the other hand, there were weak correlations between abnormal UA RI, MCA RI, MCA/UA RI and adverse perinatal outcomes of diabetic pregnancies not associated with hypertension. Therefore the results of the UA RI, MCA RI and MCA/UA RI should be interpreted with caution in the management of diabetic pregnancies, especially those not associated with hypertension, as adverse perinatal outcomes frequently occur in patients with normal Doppler indices.

Keywords: :

Diabetes mellitus, hypertension, Doppler ultrasound, Resistance index, Pregnancy

ISSN: :

1097-8135

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