The value of Middle cerebral and umbilical arteries Doppler indices in pregestational diabetic versus normal pregnancies in prediction of adverse neonatal outcome
Sediek, M., Dawoud, M., El Komy, R., El-Sherbini, M., Abd El Azeem, B., Ogila, A., Abd El Razek, A., Abd El Hameed, M. (2023). The value of Middle cerebral and umbilical arteries Doppler indices in pregestational diabetic versus normal pregnancies in prediction of adverse neonatal outcome. EKB Journal Management System, 27(4), 75-87. doi: 10.21608/egyfs.2023.317681
Mona Mohamed Sediek; Mariam Ahmed Mohamed Dawoud; Rasha Omar Fathy El Komy; Moutaz Mahmoud El-Sherbini; Basma Makin Abd El Azeem; Asmaa Ibrahim Ogila; Abd El Rahman Ahmed Abd El Razek; Mahmoud Ahmed Ismail Abd El Hameed. "The value of Middle cerebral and umbilical arteries Doppler indices in pregestational diabetic versus normal pregnancies in prediction of adverse neonatal outcome". EKB Journal Management System, 27, 4, 2023, 75-87. doi: 10.21608/egyfs.2023.317681
Sediek, M., Dawoud, M., El Komy, R., El-Sherbini, M., Abd El Azeem, B., Ogila, A., Abd El Razek, A., Abd El Hameed, M. (2023). 'The value of Middle cerebral and umbilical arteries Doppler indices in pregestational diabetic versus normal pregnancies in prediction of adverse neonatal outcome', EKB Journal Management System, 27(4), pp. 75-87. doi: 10.21608/egyfs.2023.317681
Sediek, M., Dawoud, M., El Komy, R., El-Sherbini, M., Abd El Azeem, B., Ogila, A., Abd El Razek, A., Abd El Hameed, M. The value of Middle cerebral and umbilical arteries Doppler indices in pregestational diabetic versus normal pregnancies in prediction of adverse neonatal outcome. EKB Journal Management System, 2023; 27(4): 75-87. doi: 10.21608/egyfs.2023.317681

The value of Middle cerebral and umbilical arteries Doppler indices in pregestational diabetic versus normal pregnancies in prediction of adverse neonatal outcome

The Egyptian Journal of Fertility of Sterility
Article 9, Volume 27, Issue 4 - Serial Number 11106352, July 2023, Page 75-87  XML PDF (1.02 MB)
Document Type: Original Article
DOI: 10.21608/egyfs.2023.317681
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Authors
Mona Mohamed Sediek email 1; Mariam Ahmed Mohamed Dawoud1; Rasha Omar Fathy El Komy2; Moutaz Mahmoud El-Sherbini2; Basma Makin Abd El Azeem2; Asmaa Ibrahim Ogila3; Abd El Rahman Ahmed Abd El Razek4; Mahmoud Ahmed Ismail Abd El Hameed1
1Lecturer of Obstetrics and Gynecology, Faculty of Medicine, Cairo University
2Professor of Obstetrics and Gynecology, Faculty of Medicine, Cairo University
3Assistant Professor of Obstetrics and Gynecology, Faculty of Medicine, Cairo University
4Professor of Pediatrics, Faculty of Medicine, Cairo University
Abstract
Objectives: To study the impact of pregestational DM on fetal middle cerebral (MCA) and umbilical arteries (UA) Doppler indices and hence, evaluating their diagnostic performance as predictors for adverse neonatal outcome.  
Methods: The study included 2 equal groups of 60 patients each, thus making up a total of 120 patients; control group of healthy pregnant women and study group included pregnant patients known to have pregestational diabetes. The study group was furtherly subdivided into two equal subgroups of 30 patients each. This sub classification was made according to to HbA1C levels namely; controlled diabetics (defined as those having HbA1C < 6.5 %) and uncontrolled diabetics (defined as those having values of HbA1C ≥ 6.5 %). UA, MCA Doppler indices (resistance index and pulsatility index) and Cerebroplacental Doppler ratio were measured for each patient. Neonatal outcome was assessed and recorded following delivery. The following parameters were assessed: neonatal blood sugar, 1min and 5min Apgar score and admission to neonatal intensive care unit.   
Results: The sensitivity and specificity of umbilical artery Doppler in the prediction of adverse neonatal outcomes among diabetic patients were 25% and 88.89%, respectively, while, the sensitivity and specificity of middle cerebral artery Doppler were 20.83% and 91.67%, respectively. The resistance index and pulsatility index of MCA and UA were not of significant corelation with any of the neonatal outcomes (Pearson’s r ranged -0.07 to 0.13, p > 0.05).
Conclusion:  maternal DM is not associated with significant abnormalities in Doppler indices of placental or fetal circulation. In addition, both UA and MCA had low sensitivity in the prediction of adverse neonatal outcome. 
Keywords
Keywords: Diabetes mellitus; Umbilical artery; Middle cerebral artery Doppler ultrasound and adverse neonatal outcome
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