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Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(7):352-357
DOI 10.1590/S0100-72032007000700005
PURPOSE: to analyze the pattern of fetal breathing movements (FBM) in diabetic pregnant women in the third trimester of pregnancy. METHODS: sixteen pregestational diabetic and 16 nondiabetic (control group) pregnant subjects were included fulfilling the following criteria: singleton, between 36-40 weeks of gestation, absence of other maternal diseases and absence of fetal anomalies. The fetal biophysical profile (FBP) was performed to evaluate the following parameters: fetal heart rate, FBM, fetal body movements, fetal tone and amniotic fluid index. The FBM was evaluated for 30 minutes, period when the examination was integrally recorded in VHS video for posterior analysis of the number of FBM episodes, the duration of each episode and the fetal breathing movements index (BMI). The BMI was calculated by the formula: (interval of time with FBM/total time of observation) x 100. At the beginning and in the end of the FBP maternal glucose levels were checked. The results were analyzed by the Mann-Whitney U-test and the Fisher exact test, adopting a level of significance of 5%. RESULTS: the glucose levels demonstrated significantly superior average in the diabetic group (113.3±35.3 g/dL) in relation to the normal group (78.2±14.8 g/dL, p<0.001). The average of the amniotic fluid index was higher in the group of the diabetic cases (15.5±6.4 cm) when compared with controls (10.6±2.0 cm; p=0.01). The average of the number of FBM episodes was superior in the diabetic ones (22.6±4.4) in relation to controls (14.8±2.3; p<0.0001). The average of the BMI in the diabetic patients (54.6±14.8%) was significantly higher than that in the control group (30.5±7.4%, p<0.0001). CONCLUSIONS: the elevated blood glucose levels can be associated with a different pattern in the FBM of diabetic mothers. The use of this parameter of the FBP, in the obstetric practice, must be considered with concern in diabetic pregnancies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(7):352-357
DOI 10.1590/S0100-72032007000700005
PURPOSE: to analyze the pattern of fetal breathing movements (FBM) in diabetic pregnant women in the third trimester of pregnancy. METHODS: sixteen pregestational diabetic and 16 nondiabetic (control group) pregnant subjects were included fulfilling the following criteria: singleton, between 36-40 weeks of gestation, absence of other maternal diseases and absence of fetal anomalies. The fetal biophysical profile (FBP) was performed to evaluate the following parameters: fetal heart rate, FBM, fetal body movements, fetal tone and amniotic fluid index. The FBM was evaluated for 30 minutes, period when the examination was integrally recorded in VHS video for posterior analysis of the number of FBM episodes, the duration of each episode and the fetal breathing movements index (BMI). The BMI was calculated by the formula: (interval of time with FBM/total time of observation) x 100. At the beginning and in the end of the FBP maternal glucose levels were checked. The results were analyzed by the Mann-Whitney U-test and the Fisher exact test, adopting a level of significance of 5%. RESULTS: the glucose levels demonstrated significantly superior average in the diabetic group (113.3±35.3 g/dL) in relation to the normal group (78.2±14.8 g/dL, p<0.001). The average of the amniotic fluid index was higher in the group of the diabetic cases (15.5±6.4 cm) when compared with controls (10.6±2.0 cm; p=0.01). The average of the number of FBM episodes was superior in the diabetic ones (22.6±4.4) in relation to controls (14.8±2.3; p<0.0001). The average of the BMI in the diabetic patients (54.6±14.8%) was significantly higher than that in the control group (30.5±7.4%, p<0.0001). CONCLUSIONS: the elevated blood glucose levels can be associated with a different pattern in the FBM of diabetic mothers. The use of this parameter of the FBP, in the obstetric practice, must be considered with concern in diabetic pregnancies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(8):453-459
DOI 10.1590/S0100-72032006000800003
PURPOSE: to analyze the fetal heart rate (FHR) and umbilical artery Dopplervelocimetry between 18th and 20th weeks of gestation in pregnant women complicated by pregestational diabetes mellitus. METHODS: twenty-eight pregnancies with pregestational diabetes and 27 normal pregnant women were analyzed prospectively, in a cross-sectional and case-control study. The inclusion criteria were the following: singleton pregnancy between 18 and 29 weeks, no other associated maternal diseases and no fetal abnormality. Ultrasonography was performed and FHR was calculated by the interval between the beginnings of two consecutive cardiac cycles, in the three umbilical artery Doppler sonograms, obtained in the umbilical cord near to the placental insertion, using color Doppler. Five consecutive FHR cycles from each sonogram were measured, to analyze mean FHR and its variation. The following Doppler indices were studied: systolic/diastolic ratio, pulsatility index (PI) and resistance index (RI). Student's t test and Mann-Whitney Utest were applied to comparative study. p values were considered significant when p<0.05. Results: no significant difference was observed in mean FHR between the studied groups (diabetic group: 149.2 bpm, control group: 147.2 bpm; p = 0.12). FHR variation revealed similar results between the groups (diabetic group: 5.3 bpm; control group: 5.3 bpm; p=0.50). No significant difference was found in the Doppler indices S/D (p=0.79), PI (p=0.25) and RI (p=0.71) between the groups. CONCLUSIONS: the absence of differences in FHR characteristics between the 18th and 20th gestational weeks indicates similar neurological maturation of FHR regulatory systems in this period, between fetuses of diabetic mothers and controls. Abnormalities in the uteroplacental resistance were not identified in the studied period, in pregnancies complicated by pregestational diabetes.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(8):453-459
DOI 10.1590/S0100-72032006000800003
PURPOSE: to analyze the fetal heart rate (FHR) and umbilical artery Dopplervelocimetry between 18th and 20th weeks of gestation in pregnant women complicated by pregestational diabetes mellitus. METHODS: twenty-eight pregnancies with pregestational diabetes and 27 normal pregnant women were analyzed prospectively, in a cross-sectional and case-control study. The inclusion criteria were the following: singleton pregnancy between 18 and 29 weeks, no other associated maternal diseases and no fetal abnormality. Ultrasonography was performed and FHR was calculated by the interval between the beginnings of two consecutive cardiac cycles, in the three umbilical artery Doppler sonograms, obtained in the umbilical cord near to the placental insertion, using color Doppler. Five consecutive FHR cycles from each sonogram were measured, to analyze mean FHR and its variation. The following Doppler indices were studied: systolic/diastolic ratio, pulsatility index (PI) and resistance index (RI). Student's t test and Mann-Whitney Utest were applied to comparative study. p values were considered significant when p<0.05. Results: no significant difference was observed in mean FHR between the studied groups (diabetic group: 149.2 bpm, control group: 147.2 bpm; p = 0.12). FHR variation revealed similar results between the groups (diabetic group: 5.3 bpm; control group: 5.3 bpm; p=0.50). No significant difference was found in the Doppler indices S/D (p=0.79), PI (p=0.25) and RI (p=0.71) between the groups. CONCLUSIONS: the absence of differences in FHR characteristics between the 18th and 20th gestational weeks indicates similar neurological maturation of FHR regulatory systems in this period, between fetuses of diabetic mothers and controls. Abnormalities in the uteroplacental resistance were not identified in the studied period, in pregnancies complicated by pregestational diabetes.