ArticleArchives of gynecology and obstetrics2026
Aortic isthmus Doppler hemodynamics and ımpacts on perinatal outcomes in pregestational and gestational diabetes mellitus.
Article in Archives of gynecology and obstetrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND/
aimTo assess the sensitivity of the fetal aortic isthmus (AoI) Doppler changes in predicting the adverse perinatal outcome with pregestational and gestational diabetes mellitus compared with other Doppler parameters. MATERIALS AND
methodsThis prospective case-control study was undertaken between Agust 2023 and May 2024 in Ankara Etlik City Hospital perinatology department. Maternal age, gravidity, parity, maternal body mass index (BMI), gestational age at ultrasonographic examination, fetal AoI, umbilical artery (UA), middle cerebral artery (MCA), and uterine artery (UtA) Doppler parameters were compared between four groups: Pregestational diabetes mellitus (PGDM) (n = 30), diet-regulated gestational diabetes mellitus (DRGDM) (n = 30), insulin-regulated GDM (IRGDM) (n = 30), and controls (n = 75). HbA1c values were evaluated only in pregnancies complicated by diabetes mellitus. The composite adverse perinatal outcomes (CAPO) was defined as Apgar score at 5 min < 7, cord blood pH < 7, sepsis, phototherapy for neonates, respiratory distress syndrome (RDS), mechanical ventilation, neonatal intensive care unit (NICU) admission, hypoglycemia.
resultsMaternal age and BMI levels were significantly higher in the PGDM group (p < 0.001). HbA1c levels were significantly higher in the PGDM group compared to other diabetic groups (p < 0.001). While most Doppler parameters were similar across groups, PGDM cases had higher rates of prematurity (40%), cesarean delivery (90%), NICU admission (60%), and CAPO (63.3%) compared to controls (p < 0.01 for all). HbA1c was positively correlated with MCA S/D, AoI-PSV, and AoI S/D (p < 0.05). ROC analysis showed that AoI Ta-max and EDV had modest predictive value for CAPO (AUC = 0.627 and 0.638, respectively; p < 0.05).
conclusionsThe AoI Doppler flow measurements may serve as a potential adjunctive marker in the assessment of adverse perinatal outcomes in pregnancies complicated by diabetes mellitus. However, further large-scale prospective studies are warranted to validate its clinical applicability and establish its role in routine obstetric practice.
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