Evaluation of Doppler ultrasound assessment as a Prognostic Tool in gestational diabetes

Arjun Sharma; N. Bose; S. Mehta

doi:10.5281/zenodo.22813741

Authors

Arjun Sharma Department of Gynecology, Po Research Center for Gynecology Author https://orcid.org/1783-7946-6395-4030
N. Bose Department of Gynecology, Godavari Research Center for Gynecology Author https://orcid.org/7538-8333-1383-6263
S. Mehta Department of Gynecology, Shannon Institute of Obstetrics and Maternal Health Author https://orcid.org/6817-8955-4457-3699

DOI:

https://doi.org/10.5281/zenodo.22813741

Keywords:

gestational diabetes, Doppler ultrasound, umbilical artery, cerebroplacental ratio, perinatal outcome

Abstract

Graphical abstract

Background: Glycemic control alone does not fully explain which GDM pregnancies progress to macrosomia or other adverse perinatal outcome, prompting interest in Doppler indices as adjunct prognostic markers.

Objective: To determine whether third-trimester umbilical artery, uterine artery and cerebroplacental ratio (CPR) Doppler indices independently predict adverse perinatal outcome in GDM, and whether a combined Doppler score adds discriminative value.

Methods: In a prospective cohort of singleton GDM pregnancies, umbilical, uterine and middle cerebral artery Doppler indices were obtained at 34-37 weeks and related to a composite outcome of macrosomia, non-reassuring caesarean delivery, low Apgar score, hypoglycemia or NICU admission by adjusted logistic regression.

Results: Umbilical artery pulsatility index above the 95th centile (adjusted OR 3.4, 95% CI 1.6-7.2) and CPR below the 5th centile (adjusted OR 2.9, 95% CI 1.3-6.5) were independently associated with the composite outcome, and a combined Doppler score raised the AUC from 0.66 to 0.79.

Conclusions: Third-trimester Doppler assessment identifies a physiologically distinct, higher-risk subgroup of GDM pregnancies not fully captured by glycemic control or biometry alone, supporting its use as a complementary prognostic tool.

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