Doppler Comparison Of Feto-Placental Blood Flow Characteristics Between Pre- Gestational Diabetic And Non-Diabetic Pregnant Women During Second And Third Trimester
Abstract
Background: Pre-gestational diabetes mellitus (PGDM) is known to significantly impact placental vascularization and fetal outcomes. Doppler ultrasonography serves as a non-invasive tool to assess feto-placental circulation and detect early hemodynamic alterations, crucial for managing high-risk pregnancies.
Objective: To compare feto-placental blood flow characteristics between pre-gestational diabetic and non-diabetic pregnant women using Doppler ultrasonography during the second and third trimesters.
Methods: This prospective, observational, comparative study was conducted at Kishwar Sultana Hospital, Lahore, involving 120 pregnant women—60 with pre-gestational diabetes and 60 healthy controls. Doppler ultrasound evaluated the umbilical artery parameters: peak systolic velocity (PSV), end-diastolic velocity (EDV), resistance index (RI), pulsatility index (PI), and systolic/diastolic (S/D) ratio. Placental thickness and grading were also assessed. Data were analyzed using SPSS version 20, applying the Mann-Whitney U test with a significance level set at p<0.05.
Results: Statistically significant differences were observed in all Doppler indices. Non-diabetic women exhibited higher PSV (p=0.000) and EDV (p=0.000), whereas diabetic women showed significantly elevated RI (p=0.001), PI (p=0.000), and S/D ratio (p=0.001), indicating increased vascular resistance. Placental thickness was also significantly higher in the diabetic group (p=0.000). Although Grade 3 placental maturation was more frequent among diabetics (70.6%), the association was not statistically significant (p=0.289).
Conclusion: Pre-gestational diabetes is associated with compromised feto-placental blood flow, characterized by elevated resistance indices and reduced flow velocities. These alterations underline the importance of Doppler surveillance for early detection and intervention to improve maternal and fetal outcomes in diabetic pregnancies.
Keywords
Pre-gestational Diabetes, Doppler Ultrasound, Umbilical Artery, Feto-placental Hemodynamics, Resistance Index, Placental Thickness, Vascular Impedance, High-risk Pregnancy
