Grunewald C, Divon M, Lunell N O
Department of Obstetrics and Gynecology, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden.
Acta Obstet Gynecol Scand. 1996 Oct;75(9):804-8. doi: 10.3109/00016349609054707.
To study the pulsatility index of the flow velocity waveform of the uterine and umbilical arteries and the fetal aorta in diabetic pregnancy.
Twenty-four well-controlled insulin-dependent pregestational diabetics and 25 healthy pregnant women were studied with Doppler ultrasound on two occasions separated by a one month interval in the third trimester. In the study group, a random blood glucose was sampled at the time of the Doppler examination.
At the first Doppler examination the median pulsatility index in the fetal thoracic aorta and in the uterine artery was significantly lower (p < 0.01 and p < 0.05, respectively) in the diabetic group as compared to the healthy controls, whereas the umbilical and uterine artery pulsatility indices were similar. At the second examination, a significant decrease in median pulsatility index of the umbilical artery and the fetal aorta (p < 0.01) and the uterine artery (p < 0.05) was observed in the controls whereas no such change occurred in the diabetics. There was no correlation between glycosylated hemoglobin or random blood glucose and pulsatility index values. An increased incidence of neonatal morbidity was noted in the study group.
The normal third trimester decline in uteroplacental and fetal placental pulsatility indices was absent in the diabetic group. The pulsatility index was not influenced by blood glucose regulation.
研究糖尿病妊娠时子宫动脉、脐动脉及胎儿主动脉血流速度波形的搏动指数。
选取24例血糖控制良好的孕前胰岛素依赖型糖尿病患者和25例健康孕妇，在孕晚期进行两次多普勒超声检查，两次检查间隔1个月。研究组在进行多普勒检查时采集随机血糖。
在第一次多普勒检查时，糖尿病组胎儿胸主动脉和子宫动脉的搏动指数中位数显著低于健康对照组（分别为p < 0.01和p < 0.05），而脐动脉和子宫动脉搏动指数相似。在第二次检查时，对照组脐动脉、胎儿主动脉（p < 0.01）和子宫动脉（p < 0.05）的搏动指数中位数显著下降，而糖尿病组未出现此类变化。糖化血红蛋白或随机血糖与搏动指数值之间无相关性。研究组新生儿发病率增加。
糖尿病组在孕晚期不存在子宫胎盘和胎儿胎盘搏动指数正常下降的情况。搏动指数不受血糖调节的影响。
