Kofinas A D, Penry M, Swain M
Department of Obstetrics and Gynecology, York Hospital, Pennsylvania 17405.
Am J Perinatol. 1991 Jul;8(4):273-7. doi: 10.1055/s-2007-999395.
We examined 65 pregnant women with gestational (n = 31) and insulin dependent (n = 34) diabetes mellitus in order to evaluate the clinical usefulness of Doppler flow velocity waveform analysis in these pregnancies. Umbilical and uterine artery flow velocity waveforms were obtained during the third trimester with a continuous wave Doppler device. Quality of maternal glycemic control was evaluated by hemoglobin (Hb) A1 measurements at the time of delivery in 61 patients and by mean capillary blood sugars during the third trimester of pregnancy in four patients. There was no difference in various clinical and Doppler parameters between patients with good glycemic control and those with poor control. In contrast, the same clinical and Doppler parameters were significantly different in patients with preeclampsia than in those without preeclampsia, regardless of glycemic control. There was a poor positive linear correlation (r = 0.30, p less than 0.02) between maternal HbA1 and umbilical artery flow velocity waveforms (systolic/diastolic ratio). Proteinuria correlated better with umbilical artery systolic/diastolic ratio (r = 0.49, p less than 0.001). We conclude that Doppler flow velocity waveform analysis may be clinically useful only in diabetic pregnancies complicated by preeclampsia.
我们检查了65例患有妊娠期糖尿病（n = 31）和胰岛素依赖型糖尿病（n = 34）的孕妇，以评估多普勒血流速度波形分析在这些妊娠中的临床实用性。在妊娠晚期使用连续波多普勒设备获取脐动脉和子宫动脉的血流速度波形。61例患者在分娩时通过血红蛋白（Hb）A1测量评估母体血糖控制质量，4例患者在妊娠晚期通过平均毛细血管血糖评估。血糖控制良好的患者与控制不佳的患者在各种临床和多普勒参数上没有差异。相比之下，无论血糖控制如何，子痫前期患者与无子痫前期患者的相同临床和多普勒参数存在显著差异。母体HbA1与脐动脉血流速度波形（收缩压/舒张压比值）之间存在较差的正线性相关性（r = 0.30，p < 0.02）。蛋白尿与脐动脉收缩压/舒张压比值的相关性更好（r = 0.49，p < 0.001）。我们得出结论，多普勒血流速度波形分析可能仅在并发子痫前期的糖尿病妊娠中具有临床实用性。
