Study of Umbilical Arteries in Diabetic Mothers using Doppler

Abstract

Themain objective of this study was to evaluate the S/D ratio and resistance index of the umbilical artery at a free loop in patients with diabetic pregnancy and those with normal pregnancies, also Develop national guidelines on the use of fetal Doppler in obstetrics. And To evaluate if the Doppler follow up of the umbilical artery can improve the clinical diagnosis of patients with diabetic pregnancy.A total 325 consecutive pregnant women 100 normal for control and 225 diabetic women in the second &third trimesters were enrolled in this study from maternity clinic in the maternity hospital – Alqassim-Buriada. The duration of the study extended from May 2012 to November 2016.From this study, it has been found that (41.8%) of the diabetes was Type 1 diabetes, since (48%) of diabetes was Gestational, while only (10.2%) of them was Type 2 diabetes,also shown that most (49.8%) of diabetics usesmedications to control their sugar since (30.2%) of them uses Insulin and (20%) of them Dose not use any treatment to control their sugar. For family history find that (45.4%) of diabetics have no diabetes in their families history, since (41.3%) of them have diabetes in their family history, while only (13.3%) of them have Hypertension in their family history.& find shown that the most (69.8%) of diabetics have non maternal risk, since (25.8%) of them were Cesarean Section, while only (3.6%) of them were Preeclampsia and (0.9%) of them Eclampsia. Fetal risk shown that(41.8%) of diabetics have non fetal risk, since (24%) of them were IUGR, (17.3%) of them were Polyhydramnios,(16%) were Macrosomia, while only (0.9%) of them were IUFD.And shown that the most (43.1%) of diabetics fetal outcome were Discharged, since (16%) of them were Hypoglycemia or LGA, (14.2%) of them were IUGR, while only (5.3%) of them were RDS, (3.1%) of them were Poor sucking, (0.9%) of them were Sepsis or IUFD and (0.4%) of them were DM.Notes, that (0.6%) participants were No blood flow(IUFD cases) as same as (0.6%) were Absent of end diastolic cases, since the most (89.2%) of participants were Normal, while (9.5%) of participants were Reduce of end diastolic cases.Also I find no statistically significant correlation between (RI and S/D Ratio) and Random Blood Sugar, while there are statistically significant negative relationships between Fetal weight and Doppler indices(RI and S/D Ratio)which means Fetal weight decreases as Doppler indices increase.The chi-square test and Likelihood Ratio test statisticsare (chi-square= 8.041 with Sig. = 0.782 and Likelihood Ratio = 8.399 with Sig. = 0.753),therefore, statistically non-significant association between Fetal Risk and Diabetes Type and there is statistically significant difference between the mean of RI, but there is no statistically significant difference between the mean of S/D Ratio for those people who diabetic and those who are not.