Use of umbilical artery Doppler velocimetry in the monitoring of pregnancy in women with pre-existing diabetes

Wong, S.F., Chan, F. Y., Cincotta, R., McIntyre, D. H. D. and Stone, M. (2003) Use of umbilical artery Doppler velocimetry in the monitoring of pregnancy in women with pre-existing diabetes. Australian and New Zealand Journal of Obstetrics and Gynaecology, 43 4: 302-306. doi:10.1046/j.0004-8666.2003.00094.x


Author Wong, S.F.
Chan, F. Y.
Cincotta, R.
McIntyre, D. H. D.
Stone, M.
Title Use of umbilical artery Doppler velocimetry in the monitoring of pregnancy in women with pre-existing diabetes
Journal name Australian and New Zealand Journal of Obstetrics and Gynaecology   Check publisher's open access policy
ISSN 0004-8666
Publication date 2003-01-01
Year available 2003
Sub-type Article (original research)
DOI 10.1046/j.0004-8666.2003.00094.x
Open Access Status DOI
Volume 43
Issue 4
Start page 302
End page 306
Total pages 5
Editor M Humphrey
Place of publication Australia
Publisher Blackwell Publishing Asia
Language eng
Subject C1
321014 Obstetrics and Gynaecology
730116 Reproductive system and disorders
Abstract Background: The usefulness of umbilical artery Doppler velocimetry for the monitoring of diabetic pregnancies is controversial. The aim of the present study was to assess whether umbilical artery Doppler velocity waveform analysis can predict adverse perinatal outcomes for pregnancies complicated by pre-existing diabetes mellitus. Methods: All diabetic pregnancies (type 1 and 2) delivered at Mater Mothers' Hospital, Queensland, between 1 January 1995 and 31 December 1999 were included. All pregnant diabetic women were monitored with umbilical artery Doppler velocimetry at 28, 32, 36, and 38 weeks' gestation. Adverse perinatal outcome was defined as pregnancies with one or more of the following: small-for-gestational age, Caesarean section for non-reassuring cardiotocography, fetal acidaemia at delivery, 1-min Apgar of 3 or less, 5-min Apgar of less than 7, hypoxic ischaemic encephalopathy or perinatal death. Abnormal umbilical artery Doppler velocimetry was defined as a pulsatility index of 95th centile or higher for gestation. Results: One hundred and four pregnancies in women with pre-existing diabetes had umbilical arterial Doppler studies carried out during the study period. Twenty-three pregnancies (22.1%) had an elevated pulsatility index. If the scans were carried out within 2 weeks of delivery, 71% of pregnancies with abnormal umbilical Doppler had adverse outcomes (P < 0.01; likelihood ratio, 4.2). However, the sensitivity was 35%; specificity was 94%; positive predictive value was 80%; and negative predictive value was 68%. Only 30% of women with adverse perinatal outcomes had abnormal umbilical arterial Doppler flow. Conclusion: Umbilical artery Doppler velocimetry is not a good predictor of adverse perinatal outcomes in diabetic pregnancies.
Keyword Diabetes
Doppler
Medical Disorders
Perinatal Outcome
Pregnancy
Wave-forms
Mellitus
Q-Index Code C1
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2004 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Wed, 15 Aug 2007, 12:35:17 EST