E-ISSN: 2619-9467

Contents    Cover    Publication Date: 06 Jun 2023
Year 2023 - Volume 33 - Issue 2

Open Access

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ORIGINAL RESEARCH
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Altered Right Portal and Umbilical Vein Doppler Parameters in Fetal Macrosomia Resulting from Pregestational andGestational Diabetic Mothers: A Prospective Case-Control Study
Received: 14 Oct 2022 | Received in revised form: 30 Mar 2023
Accepted: 03 Apr 2023 | Available online: 07 Apr 2023
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Salim SEZERa , Süleyman Cemil OĞLAKb , Alev ATIŞ AYDINc , Sema SÜZEN ÇAYPINARd , Başak KAYAe , Melih BESTELf
aDepartment of Perinatology, Esenyurt University Hospital, İstanbul, Türkiye
bDepartment of Obstetrics and Gynecology, Health Sciences University Gazi Yaşargil Training and Research Hospital, Diyarbakır, Türkiye
cDepartment of Perinatology, Health Sciences University Şişli Hamidiye Etfal Training and Research Hospital İstanbul, Türkiye
dDepartment of Perinatology, Health Sciences University Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Türkiye
eDepartment of Perinatology, Medipol University Hospital, İstanbul, Türkiye
fDepartment of Obstetrics and Gynecology, Esenyurt University Hospital, İstanbul, Türkiye
JCOG. 2023;33(2):88-94
DOI: 10.5336/jcog.2022-93879
Article Language: EN
Copyright Ⓒ 2020 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
 Objective: To evaluate the blood flow of the umbilical vein and right portal vein in macrosomic fetuses of diabetic mothers and investigate the effect of maternal insulin treatment on these blood flows. Material and Methods: This prospective case-control study was conducted between March 2019 and December 2019. Fetuses of the 49 pregestational and gestational diabetic mothers who had an abdominal circumference percentile above 97% were evaluated as macrosomic and formed the study group. The study group was divided into two subgroups: patients treated with insulin and those who did not. In the control group, 48 non-diabetic pregnant women with matched gestational weeks whose fetuses are at the 10-90% percentile were included. Time-averaged maximum blood velocity (TAMXV) values of the right portal vein and the free loop of the umbilical vein were measured. Results: The median right portal vein TAMXV value and umbilical vein TAMXV value were found to be significantly higher in diabetic pregnancies (16.25 cm/s, and 15.28 cm/s, respectively) than in the control group (12.76 cm/s, and 13.38 cm/s, respectively, p<0.001). Umbilical and right portal vein flows were similar in macrosomic fetuses of diabetic mothers who were treated with insulin or those who did not. While umbilical vein flow in macrosomic fetuses increased as the gestational age progressed (p=0.028), it was observed steadily in normally growing fetuses. Conclusion: The umbilical and right portal vein flows are higher in macrosomic fetuses of diabetic mothers than in appropriately grown fetuses. Maternal insulin treatment does not affect fetal umbilical vein and right portal vein blood flow in macrosomic fetuses.
KEYWORDS: Gestational diabetes mellitus; diabetes mellitus Type 2; portal vein Doppler parameters; fetal macrosomia
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