Background
Pregestational diabetes mellitus (PDM) is one of the causes of many gestational complications. This study aimed to review the effect of maternal pregestational diabetes on fetal cerebral circulation through assessment of fetal middle cerebral artery (MCA) and vertebral artery (VA) Doppler study as well as cerebroplacental ratio using MCA pulsatility index (PI)/uterine artery PI and VA PI/uterine artery PI, and to find its correlation with fetal weight.
Patients and methods
This prospective study was conducted on 40 cases, comprising 20 pregestational diabetic women and 20 comparison pregnant nondiabetic women (comparison cases). Fetal Doppler studies were done twice for pregestational diabetic patients and the comparison group. The Doppler indices such as fetal MCA, VA, and umbilical artery were assessed along with the routine obstetric ultrasound examination.
Results
Statistically significant differences were detected between pregestational diabetic and comparison cases regarding MCA peak systolic volume and VA resistivity index at mid/end of the second trimester and VA resistivity index, VA PI, and VA cerebroplacental ratio at the beginning of the third trimester. There was no correlation in PDM cases between Doppler indices and fetal weight.
Conclusion
PDM was associated with VA and MCA Doppler changes. VA Doppler is recommended along with MCA Doppler in fetal screening in high-risk pregnancies.