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Abnormal uterine Doppler is related to vasculopathy in pregestational diabetes mellitus

Pietryga, M; Brazert, J; Wender-Oegowska, E; Biczysko, R; Dubiel, M and Gudmundsson, Saemundur LU (2005) In Circulation 112(16). p.2496-2500
Abstract
Background - The aim of the study was to evaluate the relation between maternal placental Doppler velocimetry, levels of the maternal glucose, and clinical signs of vasculopathy in pregnancy complicated by pregestational diabetes mellitus. Methods and Results - A retrospective study of 155 pregestational diabetic women between the 22nd and 40th weeks of pregnancy, categorized in White classification as B, 49; C, 40; D, 22; R, 20; F, 5; and RIF, 19. Cases in classes R, F, and R/F were defined as having vasculopathy. Doppler velocimetry of umbilical and uterine arteries was evaluated for vascular impedance, both in terms of pulsatility index ( PI) for both arteries and a notch in early diastole in the uterine arteries. The last examination... (More)
Background - The aim of the study was to evaluate the relation between maternal placental Doppler velocimetry, levels of the maternal glucose, and clinical signs of vasculopathy in pregnancy complicated by pregestational diabetes mellitus. Methods and Results - A retrospective study of 155 pregestational diabetic women between the 22nd and 40th weeks of pregnancy, categorized in White classification as B, 49; C, 40; D, 22; R, 20; F, 5; and RIF, 19. Cases in classes R, F, and R/F were defined as having vasculopathy. Doppler velocimetry of umbilical and uterine arteries was evaluated for vascular impedance, both in terms of pulsatility index ( PI) for both arteries and a notch in early diastole in the uterine arteries. The last examination before delivery was used for analysis. Increased umbilical artery PI was seen in 19 and a uterine artery abnormality in 45 cases. There was a correlation between levels of HbA(1c) and increased vascular impedance in the uterine and umbilical arteries. Signs of increased uterine artery vascular impedances were significantly related to pregestational vasculopathy. In cases of small-for-gestational-age newborn infants, PI was significantly increased in uterine and umbilical arteries. Furthermore, PI in macrosomic fetuses was significantly lower than in normal infants. Abnormal uterine artery Doppler was also strongly related to adverse outcome. Conclusions - Abnormal uterine artery Doppler is related to pregestational vasculopathy and adverse outcome of pregnancy. The results suggest that the uterine arteries are affected in women with clinical signs of pregestational vasculopathy. This may influence placental perfusion and fetal well-being. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
vasculopathy, vessels, pregnancy, diabetes mellitus, perfusion
in
Circulation
volume
112
issue
16
pages
2496 - 2500
publisher
Lippincott Williams and Wilkins
external identifiers
  • wos:000232607000017
  • pmid:16230501
  • scopus:27144524567
ISSN
1524-4539
DOI
10.1161/CIRCULATIONAHA.104.492843
language
English
LU publication?
yes
id
d6c645c0-8b3d-44cf-b111-278b07466212 (old id 220402)
date added to LUP
2007-08-06 08:44:19
date last changed
2017-08-13 04:24:53
@article{d6c645c0-8b3d-44cf-b111-278b07466212,
  abstract     = {Background - The aim of the study was to evaluate the relation between maternal placental Doppler velocimetry, levels of the maternal glucose, and clinical signs of vasculopathy in pregnancy complicated by pregestational diabetes mellitus. Methods and Results - A retrospective study of 155 pregestational diabetic women between the 22nd and 40th weeks of pregnancy, categorized in White classification as B, 49; C, 40; D, 22; R, 20; F, 5; and RIF, 19. Cases in classes R, F, and R/F were defined as having vasculopathy. Doppler velocimetry of umbilical and uterine arteries was evaluated for vascular impedance, both in terms of pulsatility index ( PI) for both arteries and a notch in early diastole in the uterine arteries. The last examination before delivery was used for analysis. Increased umbilical artery PI was seen in 19 and a uterine artery abnormality in 45 cases. There was a correlation between levels of HbA(1c) and increased vascular impedance in the uterine and umbilical arteries. Signs of increased uterine artery vascular impedances were significantly related to pregestational vasculopathy. In cases of small-for-gestational-age newborn infants, PI was significantly increased in uterine and umbilical arteries. Furthermore, PI in macrosomic fetuses was significantly lower than in normal infants. Abnormal uterine artery Doppler was also strongly related to adverse outcome. Conclusions - Abnormal uterine artery Doppler is related to pregestational vasculopathy and adverse outcome of pregnancy. The results suggest that the uterine arteries are affected in women with clinical signs of pregestational vasculopathy. This may influence placental perfusion and fetal well-being.},
  author       = {Pietryga, M and Brazert, J and Wender-Oegowska, E and Biczysko, R and Dubiel, M and Gudmundsson, Saemundur},
  issn         = {1524-4539},
  keyword      = {vasculopathy,vessels,pregnancy,diabetes mellitus,perfusion},
  language     = {eng},
  number       = {16},
  pages        = {2496--2500},
  publisher    = {Lippincott Williams and Wilkins},
  series       = {Circulation},
  title        = {Abnormal uterine Doppler is related to vasculopathy in pregestational diabetes mellitus},
  url          = {http://dx.doi.org/10.1161/CIRCULATIONAHA.104.492843},
  volume       = {112},
  year         = {2005},
}