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Antenatal Umbilical Coiling Index in Gestational Diabetes Mellitus and Non-Gestational Diabetes Pregnancy Publisher Pubmed



Najafi L1 ; Khamseh ME1 ; Kashanian M2 ; Younesi L3 ; Abedini A4 ; Valojerdi AE1 ; Amoei Z4 ; Khashe Heiran EN2 ; Keshtkar AA5 ; Malek M6
Authors
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Authors Affiliations
  1. 1. Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, 15937-16615, Iran
  2. 2. Department of Obstetrics & Gynecology, Akbarabadi Teaching Hospital, Iran University of Medical Sciences (IUMS), Tehran, 1168743514, Iran
  3. 3. Akbarabadi Teaching Hospital, Iran University of Medical Sciences (IUMS), Tehran, 1168743514, Iran
  4. 4. Kamali Teaching Hospital, Alborz University of Medical Sciences, Karaj, 3134877179, Iran
  5. 5. Department of Health Sciences Education Development, Tehran University of Medical Sciences, Tehran, 3439123900, Iran
  6. 6. Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, 15937-16615, Iran

Source: Taiwanese Journal of Obstetrics and Gynecology Published:2018


Abstract

Objective: Umbilical cord abnormalities increase fetal morbidity and mortality. This study was designed to compare antenatal umbilical coiling index (aUCI) in gestational diabetes mellitus (GDM) and non-gestational diabetes mellitus (non-GDM) pregnancy, considering uncertainties about the best time to perform antenatal ultrasonography scan. Materials and Methods: In this prospective study, 246 parturients were included, 123 with GDM and 123 with non-GDM pregnancy. Gestational diabetes was confirmed at 24–28 weeks of gestation (WG) using one-step strategy. An anatomical ultrasound survey of placenta and umbilical cord was performed at 18–23 as well as 37–41 weeks of gestational age. Results: At 18–23 WG, the frequency distribution (10th, 90th percentiles, mean ± SD) of the aUCI in the GDM and non-GDM groups were (0.13,0.66,0.32 ± 0.19) and (0.18,0.74, 0.4 ± 0.31) respectively. These values were (0.12,0.4, 0.25 ± 0.11) in the GDM group at 37–41 WG and (0.17,0.43, 0.29 ± 0.11) in the non-GDM group. A significant relationship was detected between UCI value and GDM/non-GDM groups at both antenatal evaluations (18–23 WG; P = 0.002, 37–41WG; P < 0.001). A significant association at 18–23 WG was found between GDM/non-GDM groups and aUCI categorization (hypocoiling <10th, normocoiling 10th–90th and hypercoiling >90th) (P = 0.001). However, hypocoiling were significantly more frequent in GDM than non-GDM in both antenatal evaluations (P < 0.001, P = 0.006). Conclusion: Antenatal UCI in pregnancy complicated by GDM were lower in comparison with non-GDM pregnancy. The most abnormal pattern of coiling in gestational diabetes was hypocoiling in both trimesters. In addition, 18–23 WG is the best time to perform ultrasound scan to detect aUCI and umbilical cord pattern. © 2018
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