Cai Dongmei, Yan Su
Gynaecology and obstetrics, Haian City People's Hospital of Jiangsu Province, Haian, 226600, Jiangsu, China.
Obstetrics, Luzhou People's Hospital, Luzhou City, Sichuan Province, 646000, China.
Heliyon. 2024 Apr 25;10(11):e30352. doi: 10.1016/j.heliyon.2024.e30352. eCollection 2024 Jun 15.
It was to investigate the diagnosis of fetal hemodynamics in pregnant women with diabetes mellitus in the third trimester of pregnancy by color Doppler ultrasonography.
55 women with gestational diabetes mellitus (GDM) in the third trimester of pregnancy who were clinically diagnosed and treated in Haian City People's Hospital of Jiangsu Province were selected as the observation group, and 55 pregnant women with normal prenatal examination results were selected as the controls. The hemodynamic parameters of fetal middle cerebral artery (MCA), umbilical artery (UA), and renal artery (RA) were detected, including the ratio of maximum systolic blood flow velocity to end-diastolic blood flow velocity (S/D), resistance index (RI) and arterial pulsation index (PI). Fasting serum levels of maternal patients were collected for detecting Cystain C (Cys C) and homocysteine (Hcy) to analyze the predictive value of serological indexes and target arterial hemodynamics parameters for adverse pregnancy outcome (APO).
The results showed that compared with controls, in the observation group, RI, PI, and S/D of MCA and RA increased significantly, while RI, PI and S/D of UA decreased obviously ( 0.05), the levels of serum Cys C and Hcy were clearly increased ( 0.05). The APO rate of controls and observation group was 10.91 % and 25.45 %, respectively. It was found that the area under the curve of serum Cys C, Hcy, and the APO predicted by the hemodynamic parameters of fetal MCA, UA, and RA were all greater than 0.75 ( 0.05). Multiple Logistic regression analysis showed that serum Cys C and Hcy, and the hemodynamic parameters of fetal MCA, UA and RA were correlated with APO ( < 0.05).
In summary, maternal blood glucose level can affect fetal hemodynamic parameters. In the third trimester of pregnancy, the changes of blood flow parameters of fetal MCA, UA, RA, and maternal serum Cys C and Hcy levels are helpful to understand fetal status in utero, and can be used to predict APO.
探讨彩色多普勒超声检查对妊娠晚期糖尿病孕妇胎儿血流动力学的诊断价值。
选取江苏省海安市人民医院临床诊断并治疗的55例妊娠晚期妊娠期糖尿病（GDM）孕妇作为观察组，选取55例产前检查结果正常的孕妇作为对照组。检测胎儿大脑中动脉（MCA）、脐动脉（UA）和肾动脉（RA）的血流动力学参数，包括收缩期最大血流速度与舒张末期血流速度之比（S/D）、阻力指数（RI）和动脉搏动指数（PI）。采集孕妇空腹血清，检测胱抑素C（Cys C）和同型半胱氨酸（Hcy），分析血清学指标和目标动脉血流动力学参数对不良妊娠结局（APO）的预测价值。
结果显示，与对照组相比，观察组MCA和RA的RI、PI及S/D明显升高，而UA的RI、PI及S/D明显降低（P<0.05），血清Cys C和Hcy水平明显升高（P<0.05）。对照组和观察组的APO发生率分别为10.91%和25.45%。发现血清Cys C、Hcy以及胎儿MCA、UA、RA血流动力学参数预测APO的曲线下面积均大于0.75（P<0.05）。多因素Logistic回归分析显示，血清Cys C、Hcy以及胎儿MCA、UA、RA的血流动力学参数与APO相关（P<0.05）。
综上所述，孕妇血糖水平可影响胎儿血流动力学参数。在妊娠晚期，胎儿MCA、UA、RA血流参数及孕妇血清Cys C、Hcy水平的变化有助于了解胎儿宫内状况，可用于预测APO。
