Doppler comparison of fetoplacental blood flow characteristics between pre-gestational diabetic and non-diabetic pregnant women during second and third trimester of pregnancy

ABSTRACT

Objective. To compare the fetoplacental blood flow characteristics and placental thickness between diabetic vs non-diabetic pregnant women during second and third trimester.
Materials and Methods. It was case-control study. Sample size was 186. Pre-gestational diabetic and non-diabetic pregnant women between 20-35 years, with normal singleton, pregnancy at 20–42 weeks of gestational age were included. Females with maternal hypertension, intrauterine growth restriction, small /large for gestational age and any other fetal anomaly were excluded.
Results. Diabetic mothers had a peak systolic velocity of 37.05 ± 7.59 cm/s compared to 37.95 ± 7.03 cm/s in non-diabetics. However, end-diastolic velocity was significantly lower in diabetics 12.13 ± 3.85 cm/s than in non-diabetics 15.38 ± 3.63 cm/s, (P-Value: 0.000). The systolic/diastolic ratio was higher in diabetics 3.11 ± 0.81 compared to non-diabetics 2.54 ± 0.40, also statistically significant. Additionally, diabetics had a higher resistive index of 1.15 ± 0.45 versus 0.90 ± 0.16 in non-diabetics (P-Value: 0.000). The pulsatility index was 0.67 ± 0.09 in diabetics and 0.59 ± 0.06 in non-diabetics, showing a significant difference. Placental thickness was greater in diabetics 4.03 ± 0.40 mm compared to non-diabetics 3.51 ± 0.47 mm (P-Value: 0.000).
Conclusions. Our study found that Doppler parameters were significantly changed in the diabetic pregnancy: the EDV is lower, and the S/D ratio is higher, while the RI and PI are increased. The findings reveal that PSV and EDV increase significantly from the second to the third trimester, indicating enhanced placental blood flow as pregnancy progresses.