Prediction Of The Fetal Outcome Of Diabetic Pregnancies. Uterine and Umbilical Arteries Dopple,r And Biochemical Studies. •

Abstract

ln this conducted study, ninety patients were included. Diabc:ic insulin control group, composed of 40 patients who were well controlled on insulin therapy previous to their presentation at 34-35W gestation. Diabetic diet control group, composed of 20 patients who were first discovered to be diabetics at 34-.3SW gestation and were well controlled on diet alone. And a control group, composed of 30 patients who were non diabetics.

• Although our diabetic patients were found to have a well glycemic control, insulin levels and the calculated insulin resistance exhibited a different phenomenon. The more the insulin resistance, the more the grade of diabetes and the more liable the complications to occur. Thus we recommend fasting insulin level among the routine invcstigatioiiS of diabetic pregnancy. • Serum triglyccrides were found to increase gradually during normal pregnancy to reach higher levds 1 han the non pregnant normal values only from 36\V gestation onwards. Furthermore, the more advanced the diabetic status during pregnancy ( insuliO control versus diet control), the higher the levels of serum triglyceri"dcs. Also, it was evident that the triglycerides level increases progressively and significantly with the advance of pregnancy in all the studied groups.

• The degree of severity of the diabetic state was found to accelerate placental aging. Pre-eclampsia was found to further accclcrat•c that condition.

• Abnormal uterine and\or umbilical artery Doppler were found mostly among the diabetic individuals who were complic.ated by pre­ eclampsia. Thus the presence of pre-eclampsia is probably the main cause of abnormal uterine and\or umbilical artel)' Doppler in well controlled diabetic patients in absence of diabetic vascular