The Correlation of Ultrasonographic and Pathophysiologic Measurements of Umbilical Vessels in Gestational Diabetes 1

Jakó, Mária and Surányi, Andrea and Kaizer, László and Domokos, Dóra and Bártfai, György (2017) The Correlation of Ultrasonographic and Pathophysiologic Measurements of Umbilical Vessels in Gestational Diabetes 1. Southeastern European Medical Journal, 1 (1). pp. 40-49. ISSN 2459-9484

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Abstract

Aim: The resistance of placental blood vessels might be increased in diabetic pregnancies. This increased resistance can affect uteroplacental blood flow and influence the oxygen and nutrient supply of the fetus and fetal growth. Our aim was to compare the ultrasonographic, pathomorphologic data and vasoreactivity of umbilical and placental vessels of gestational diabetic newborns with that of normal pregnancy newborns. Methods: In this case-control study the placental vascularization of pregnant women was determined by 3D power Doppler ultrasound technique. We calculated the vascularization index (VI), flow index (FI) and vascularization flow index (VFI). We performed a tissue bath experiment (treatment with oxytocin and desmopressin) on umbilical vessels and collected pathomorphologic data according to the Royal College of Pathologists’ 2011 protocol. Results: The placental vascularization index and the umbilical artery S/D were significantly lower in the case group. The mean VI was 6.21% (±2.69 SD) in control versus 3.5% (±2.97 SD) (p<0.05) in GDM. The mean value of the umbilical artery S/D was 2.27 (±0.22 SD) and 2.18 (±0.45 SD) (p<0.05) respectively. In an isolated tissue bath experiment, oxytocin and desmopressin did not elicit significant contraction on umbilical cord vessels. Conclusion: Our results suggest that umbilical vessels might have a different receptor pathway regulation that can compensate for the rheological changes in the pregnant woman’s blood flow and gives opportunity for selective therapy to fetuses more vulnerable to hypoxia. (Jakó M, Surányi A, Kaizer L, Domokos D, Bártfai G. The Correlation of Ultrasonographic and Pathophysiologic Measurements of Umbilical Vessels in Gestational Diabetes. SEEMEDJ 2017;1(1);40- 49)

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