Elhelaly Amr M, Elnaggar Ahmed K, Mohamed Magd El Din M, Abdelfattah Mahmoud H, Farag Amr H
Department of Obstetrics and Gynecology, Ain Shams University Maternity Hospital, Cairo, Egypt.
Department of Obstetrics and Gynecology, Walsall Manor Hospital, Walsall, UK.
J Obstet Gynaecol Res. 2020 Aug;46(8):1326-1332. doi: 10.1111/jog.14271. Epub 2020 Jun 25.
Comparing placental volume (PV) and vascular indices in pregestational diabetic and nondiabetic pregnant women at 11 and 13 weeks gestation.
A case-control study conducted at Ain Shams University Maternity Hospital in collaboration with Feto-maternal Unit for Ultrasound Assessment, Ain Shams University Maternity Hospital, Egypt. Ninety-two pregnant women divided into two groups: Group A included 46 women with pregestational diabetes mellitus and group B included 46 nondiabetic pregnant women as control. All participants had PV, vascularization index (VI), flow index (FI) and vascularization flow index (VFI) calculated using three-dimensional (3D) ultrasonography and 3D power Doppler at 11 and 13 weeks of pregnancy.
At 11 weeks, the mean VI, FI and VFI in diabetic group (17.70 ± 12.62, 40.72 ± 11.03 and 7.77 ± 6.37, respectively) were insignificantly higher than in nondiabetic group (12.14 ± 12.62, 34.59 ± 9.66 and 6.52 ± 14.20, respectively) while mean PV in diabetic group (26.90 ± 14.74) was insignificantly lower than in nondiabetic group (27.53 ± 17.46). Also at 13 weeks, the results were not different as the mean VI, FI and VFI in diabetic group (16.51 ± 9.81, 42.52 ± 7.47 and 8.12 ± 7.55, respectively) were insignificantly higher than in nondiabetic group (16.37 ± 14.17, 40.29 ± 17.52 and 7.08 ± 4.35, respectively), and mean PV in diabetic group (52.04 ± 17.95) was insignificantly lower than in nondiabetic group (54.46 ± 17.85). There was strong positive correlation between HbA1C level and VFI measured at 13 weeks gestation.
Placental indices in early pregnancy do not seem to be useful markers to anticipate placental pathology in pregestational diabetes, however there might be a role for HbA1C level measurement to anticipate such complications.
比较妊娠11周和13周时孕前糖尿病孕妇和非糖尿病孕妇的胎盘体积（PV）及血管指数。
在埃及艾因·沙姆斯大学妇产医院与艾因·沙姆斯大学妇产医院胎儿-母亲超声评估科合作开展一项病例对照研究。92名孕妇分为两组：A组包括46名孕前糖尿病女性，B组包括46名非糖尿病孕妇作为对照。所有参与者在妊娠11周和13周时使用三维（3D）超声和3D能量多普勒计算PV、血管化指数（VI）、血流指数（FI）和血管化血流指数（VFI）。
在11周时，糖尿病组的平均VI、FI和VFI（分别为17.70±12.62、40.72±11.03和7.77±6.37）略高于非糖尿病组（分别为12.14±12.62、34.59±9.66和6.52±14.20），而糖尿病组的平均PV（26.90±14.74）略低于非糖尿病组（27.53±17.46）。同样在13周时，结果无差异，因为糖尿病组的平均VI、FI和VFI（分别为16.51±9.81、42.52±7.47和8.12±7.55）略高于非糖尿病组（分别为16.37±14.17、40.29±17.52和7.08±4.35），且糖尿病组的平均PV（52.04±17.95）略低于非糖尿病组（54.46±17.85）。妊娠13周时测得的糖化血红蛋白（HbA1C）水平与VFI之间存在强正相关。
孕早期的胎盘指数似乎并非预测孕前糖尿病胎盘病变的有用指标，然而，测量HbA1C水平可能对预测此类并发症有一定作用。
