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75g 口服葡萄糖耐量试验对健康妊娠中母胎多普勒参数的影响:一项横断面观察性研究。

The effect of 75-g oral glucose tolerance test on maternal and foetal Doppler parameters in healthy pregnancies: a cross-sectional observational study.

机构信息

Faculty of Medicine, Department of Perinatology, Istanbul Medeniyet University, Istanbul, Turkey.

Faculty of Medicine, Department of Obstetrics and Gynecology, Istanbul Medeniyet University, Istanbul, Turkey.

出版信息

J Obstet Gynaecol. 2021 Jan;41(1):83-88. doi: 10.1080/01443615.2020.1849072. Epub 2021 Feb 15.

DOI:10.1080/01443615.2020.1849072
PMID:33583317
Abstract

Hyperglycaemia can alter placental resistance to blood flow and hyperglycaemia has adverse perinatal outcomes. Oral glucose tolerance testing (OGTT) increases the maternal plasma glucose levels temporarily and mimics metabolic hyperglycaemia. The blood flow of the uterine artery (UtA), umbilical artery (UA), middle cerebral artery (MCA) were assessed before, 1 and 2 h following the OGTT by using Doppler ultrasonography. Z-score of cerebroplacental ratio (CPR), pulsatility index (PI) for three vessels were evaluated separately. All measurements of the MCA, UA, UtA Doppler parameters were not statistically different for fasting, and 1 and 2 h following the 75 g OGTT in the 53 pregnant women with a singleton gestation in the low-risk group. This study results show that acute hyperglycaemia induced by OGTT has no effect on maternal and foetal Doppler parameters in healthy pregnancies.IMPACT STATEMENT Foetal glucose is affected by maternal blood glucose concentrations and placental blood flow. Acute hyperglycaemia may have an effect on maternal, and foetal Doppler parameters among healthy pregnancies Our findings indicate that blood flow velocity metric measurements in the UA, MCA and UtA were not affected by the OGTT in healthy pregnant women. Acute hyperglycaemia induced by OGTT does not have any effect on fetomaternal circulation, especially foetal brain blood flow. Other foetal vessels including ductus venosus, renal artery, etc. may be affected by maternal blood glucose levels during the OGTT or in diabetic patients. Future prospective studies consisting of diabetic patients are warranted to verify the exact effect of glucose levels on foetal and maternal circulation.

摘要

高血糖会改变胎盘对血流的阻力,高血糖对围产期有不良结局。口服葡萄糖耐量试验(OGTT)会暂时升高母体血浆葡萄糖水平,模拟代谢性高血糖。通过多普勒超声检查,在 OGTT 前、1 小时和 2 小时评估子宫动脉(UtA)、脐动脉(UA)和大脑中动脉(MCA)的血流。分别评估脑胎盘比值(CPR)和三血管搏动指数(PI)的 Z 评分。在低危组的 53 例单胎妊娠孕妇中,OGTT 后空腹和 1 小时、2 小时,所有 MCA、UA、UtA 多普勒参数的测量值在统计学上均无差异。这项研究结果表明,OGTT 引起的急性高血糖对健康妊娠的母胎多普勒参数没有影响。

胎儿的血糖受母体血糖浓度和胎盘血流的影响。急性高血糖可能会对健康妊娠的母体和胎儿多普勒参数产生影响。

我们的研究结果表明,在健康孕妇中,UA、MCA 和 UtA 的血流速度测量值不受 OGTT 的影响。OGTT 引起的急性高血糖对胎儿-母体循环没有任何影响,特别是胎儿大脑的血流。在 OGTT 期间或在糖尿病患者中,其他胎儿血管,如静脉导管、肾动脉等,可能会受到母体血糖水平的影响。未来需要进行包括糖尿病患者在内的前瞻性研究,以验证血糖水平对胎儿和母体循环的确切影响。

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