Biomaterial Database

Doppler flow velocimetry of the uterine and uteroplacental circulation in pregnancies complicated by insulin-dependent diabetes mellitus. 1994

P Zimmermann, and E Kujansuu, and R Tuimala

Department of Obstetrics and Gynecology, University Hospital, Tampere, Finland.

In forty-three pregnancies complicated by insulin-dependent diabetes mellitus, 16 classified White B, 11 White C, 8 White D and 8 White R or F, the resistance-index (PR index) in the main part of the uterine artery and arcuate uterine arteries was measured by duplex-pulsed wave Doppler ultrasound. Recordings of 24 hours' blood glucose profile and glycosylated hemoglobin were parameters of glycemic control. Vascular resistance in the main uterine artery decreased with proceeding gestation as a non-diabetic pregnancy. The uterine artery supplying the placental had lower resistance than the opposite side, with a mean PR index of 0.559 (SD 0.117) and 0.622 (SD 0.133), respectively. The mean difference between both sides was 0.062 (SD 0.102) (p < 0.001). The uterine artery PR index was slightly higher in the presence of evident morphological vasculopathy, with a mean PR index of 0.591 (SD 0.104) in White D*/R/F diabetics and 0.545 (SD 0.063) in White B/C/D#, respectively (p = 0.148). Additionally more than half of the diabetics without manifest complications (B/C/D#) showed a persistent notch. Long- and short-term glycemic control was unrelated to vascular resistance in the uterine artery, with correlation coefficients of 0.027 (p = 0.746) and 0.051 (p = 0.537) for glucose and HbA1C, respectively. Doppler velocimetry could not predict diabetic specific fetal mobidity. Vascular resistance in the uterine arcuate arteries was significantly lower in the subplacental region, with a mean PR index of 0.367 (SD 0.056) compared to 0.427 (SD 0.064) in areas distant to the placenta (p < 0.0005). It was not related to vasculopathy elsewhere. CONCLUSIONS in patients with diabetic vasculopathy the uterine artery is also affected, but there is no relationship with long- or short-term parameters of glycemic control. Doppler flow velocimetry of the uterine artery is a poor predictor of diabetes-specific fetal morbidity; if normal ranges of non-diabetic pregnancies are used for reference. Because of significantly different vascular resistance in the two main uterine arteries, mean values of both-side measurements should be used for analysis, whenever possible.

UI	MeSH Term	Description	Entries
D008137	Longitudinal Studies	Studies in which variables relating to an individual or group of individuals are assessed over a period of time.	Bogalusa Heart Study,California Teachers Study,Framingham Heart Study,Jackson Heart Study,Longitudinal Survey,Tuskegee Syphilis Study,Bogalusa Heart Studies,California Teachers Studies,Framingham Heart Studies,Heart Studies, Bogalusa,Heart Studies, Framingham,Heart Studies, Jackson,Heart Study, Bogalusa,Heart Study, Framingham,Heart Study, Jackson,Jackson Heart Studies,Longitudinal Study,Longitudinal Surveys,Studies, Bogalusa Heart,Studies, California Teachers,Studies, Jackson Heart,Studies, Longitudinal,Study, Bogalusa Heart,Study, California Teachers,Study, Longitudinal,Survey, Longitudinal,Surveys, Longitudinal,Syphilis Studies, Tuskegee,Syphilis Study, Tuskegee,Teachers Studies, California,Teachers Study, California,Tuskegee Syphilis Studies
D010920	Placenta	A highly vascularized mammalian fetal-maternal organ and major site of transport of oxygen, nutrients, and fetal waste products. It includes a fetal portion (CHORIONIC VILLI) derived from TROPHOBLASTS and a maternal portion (DECIDUA) derived from the uterine ENDOMETRIUM. The placenta produces an array of steroid, protein and peptide hormones (PLACENTAL HORMONES).	Placentoma, Normal,Placentome,Placentas,Placentomes
D011247	Pregnancy	The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.	Gestation,Pregnancies
D011254	Pregnancy in Diabetics	The state of PREGNANCY in women with DIABETES MELLITUS. This does not include either symptomatic diabetes or GLUCOSE INTOLERANCE induced by pregnancy (DIABETES, GESTATIONAL) which resolves at the end of pregnancy.	Pregnancy in Diabetes,Pregnancy in Diabete,Pregnancy in Diabetic
D011256	Pregnancy Outcome	Results of conception and ensuing pregnancy, including LIVE BIRTH; STILLBIRTH; or SPONTANEOUS ABORTION. The outcome may follow natural or artificial insemination or any of the various ASSISTED REPRODUCTIVE TECHNIQUES, such as EMBRYO TRANSFER or FERTILIZATION IN VITRO.	Outcome, Pregnancy,Outcomes, Pregnancy,Pregnancy Outcomes
D012044	Regression Analysis	Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.	Regression Diagnostics,Statistical Regression,Analysis, Regression,Analyses, Regression,Diagnostics, Regression,Regression Analyses,Regression, Statistical,Regressions, Statistical,Statistical Regressions
D001783	Blood Flow Velocity	A value equal to the total volume flow divided by the cross-sectional area of the vascular bed.	Blood Flow Velocities,Flow Velocities, Blood,Flow Velocity, Blood,Velocities, Blood Flow,Velocity, Blood Flow
D001786	Blood Glucose	Glucose in blood.	Blood Sugar,Glucose, Blood,Sugar, Blood
D003922	Diabetes Mellitus, Type 1	A subtype of DIABETES MELLITUS that is characterized by INSULIN deficiency. It is manifested by the sudden onset of severe HYPERGLYCEMIA, rapid progression to DIABETIC KETOACIDOSIS, and DEATH unless treated with insulin. The disease may occur at any age, but is most common in childhood or adolescence.	Diabetes Mellitus, Brittle,Diabetes Mellitus, Insulin-Dependent,Diabetes Mellitus, Juvenile-Onset,Diabetes Mellitus, Ketosis-Prone,Diabetes Mellitus, Sudden-Onset,Diabetes, Autoimmune,IDDM,Autoimmune Diabetes,Diabetes Mellitus, Insulin-Dependent, 1,Diabetes Mellitus, Type I,Insulin-Dependent Diabetes Mellitus 1,Juvenile-Onset Diabetes,Type 1 Diabetes,Type 1 Diabetes Mellitus,Brittle Diabetes Mellitus,Diabetes Mellitus, Insulin Dependent,Diabetes Mellitus, Juvenile Onset,Diabetes Mellitus, Ketosis Prone,Diabetes Mellitus, Sudden Onset,Diabetes, Juvenile-Onset,Diabetes, Type 1,Insulin Dependent Diabetes Mellitus 1,Insulin-Dependent Diabetes Mellitus,Juvenile Onset Diabetes,Juvenile-Onset Diabetes Mellitus,Ketosis-Prone Diabetes Mellitus,Sudden-Onset Diabetes Mellitus
D005260	Female		Females