Jundishapur Scientific Medical Journal

Jundishapur Scientific Medical Journal

Comparison of Doppler Changes in Fetal Umbilical and Middle Cerebral Arteries to Polyhydramnios in Diabetic and Non-Diabetic Mothers

Document Type : Original Article

Authors
Fatemeh Zare Malek Abad 1
Mahsa Karbasi 2
Shamsi Abbasalizadeh 3
Masoomeh Raoufi 4
Hussein Soleimantabar 4
Fatemeh Ghatreh Samani 5
1 Specialized in Radiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
2 Assistant Professor of Radiology, Department of Radiology, Faculty of Medicine, Alzahra Hospital, Imam Reza Medical Research & Training Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
3 Professor of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Faculty of Medicine, Women's Reproductive Health Research Center, Clinical Research Institute, Alzahra Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
4 Assistant Professor of Radiology, Department of Radiology, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
5 Associate Professor of Radiology, Department of Radiology, School of Medicine, Alzahra Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
10.32592/JSMJ.23.4.355
Abstract
Background and Objectives Evaluation of amniotic fluid is one of the main variables of examining fetal health in the second and third trimesters of pregnancy. An increase in amniotic fluid can affect the health of the fetus. The aim of this study is to compare the severity of blood flow disorder in the umbilical artery and MCA of the fetus in idiopathic polyhydramnios (IP) and diabetic polyhydramnios (DP).
Subjects and Methods In this study, singleton pregnancies with a calendar age of 31 to 40 weeks along with DP and IP were included in the study from June 2019 to June 2019, following the inclusion and exclusion criteria. First, the patients were divided into two groups, diabetic and non-diabetic, and then each group was divided into three groups with mild, moderate, and severe polyhydramnios. In all cases, the amniotic fluid index and after fetal Doppler cytometry, pulsation index, systolic to diastolic ratio of the umbilical artery, and pulsation index, maximum systolic velocity, systolic to diastolic ratio of the middle cerebral artery were measured.
Results In this study, 138 pregnant mothers with polyhydramnios in the third trimester (70 in the IP group and 68 in the DP group) were studied. Compared to the standard values, 14 (20%) of the patients in the IP group and 10 (14.7%) in the DP group had abnormal fetal Doppler indices.
In the idiopathic group, Doppler indices of the umbilical artery differed significantly only in the severe subgroup compared to the other two subgroups. Doppler indices of the middle cerebral artery, except for maximum systolic velocity, differed significantly in the moderate and severe polyhydramnios subgroups compared to the other subgroups. The impairment of fetal umbilical and middle cerebral artery Doppler indices, except for the umbilical artery systolic-to-diastolic ratio, was not associated with whether the polyhydramnios was diabetic or idiopathic. There was no significant difference between the two groups for the other indices, and this impairment was only related to the severity of polyhydramnios.
Conclusion Disturbance in fetal Doppler indices in mothers with polyhydramnios is related to the severity of this complication and has no relation with its cause. Therefore, maintenance treatments can be useful to reduce the relative volume of amniotic fluid in both groups.
Keywords
Polyhydramnios
Amniotic fluid index
Color Doppler sonography
Umbilical artery
Middle cerebral artery
Subjects

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Jundishapur Scientific Medical Journal
Volume 23, Issue 4 - Serial Number 151
September and October 2024
Pages 359-367

  • Receive Date 02 April 2024
  • Revise Date 13 May 2024
  • Accept Date 14 May 2024