ABSTRACT
The effect of maternal hyperglycemia on fetal regional circulation in appropriate
for gestational age and small for gestational age fetuses was evaluated. Color Doppler
flow imaging and pulsed Doppler ultrasonographic assessments were made on 15 appropriate
for gestational age and 19 small for gestational age fetuses, ranging from 33 to 40
weeks' gestation before, 60 minutes, and 120 minutes after a maternal 75 g glucose
load. The pulsatility index (PI) was calculated for middle cerebral artery, descending
aorta, splenic artery, renal artery, femoral artery, and umbilical artery. Simultaneously,
maternal plasma glucose concentration was measured. Baseline PI value (1.50 ± 0.31)
for middle cerebral artery in small for gestational age fetuses was significantly
lower than that (1.89 ± 0.37) in appropriate for gestational age fetuses (p <0.05); however, there were no significant differences in baseline PI values for
other arteries in both groups. In appropriate for gestational age fetuses, the mean
PI decreased from 1.89 ± 0.37 to 1.47 ± 0.33 at 60 minutes, and to 1.55 ± 0.32 at
120 minutes (p <0.05), but no changes were found in the other arteries. In small for gestational
age fetuses, there was no significant change in PI value for each artery before and
after maternal glucose load. Maternal hyperglycemia induces a significant decrease
in cerebrovascular resistance in appropriate for gestational age fetuses but not in
small for gestational age fetuses. These results provide a foundation for evaluating
the effect of maternal hyperglycemia on fetal regional circulation.
Keywords
Maternal hyperglycemia - fetal regional circulation - appropriate for gestational
age - small for gestational age
