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CC BY 4.0 · Ultrasound Int Open 2025; 11: a25540806
DOI: 10.1055/a-2554-0806
Original Article

Fetomaternal Doppler sonography for the prediction of perinatal outcome in term pregnancies complicated by gestational diabetes mellitus: does it have potential?

Oliver Graupner 
1   Department of Obstetrics and Gynecology, University Hospital Aachen, Aachen, Germany (Ringgold ID: RIN39058)
2   Department of Obstetrics and Gynecology, Klinikum rechts der Isar der Technischen Universität München, Munchen, Germany (Ringgold ID: RIN27190)
,
Caroline Rath
1   Department of Obstetrics and Gynecology, University Hospital Aachen, Aachen, Germany (Ringgold ID: RIN39058)
,
Linda Lecker
1   Department of Obstetrics and Gynecology, University Hospital Aachen, Aachen, Germany (Ringgold ID: RIN39058)
,
Jochen Ritgen
3   Praenatalplus, Cologne, Germany
1   Department of Obstetrics and Gynecology, University Hospital Aachen, Aachen, Germany (Ringgold ID: RIN39058)
,
Bernhard Haller
4   Institute for Medical Informatics, Statistics and Epidemiology (IMedIS), University Hospital rechts der Isar, Technical University of Munich, Munich, Germany
,
Christian Enzensberger
1   Department of Obstetrics and Gynecology, University Hospital Aachen, Aachen, Germany (Ringgold ID: RIN39058)
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Abstract

Purpose

Little is known about the benefit and interpretation of fetomaternal Doppler sonography in GDM for the prediction of an adverse perinatal outcome (APO). The aim of this study was to examine the performance of fetomaternal Doppler for APO prediction in pregnancies with GDM at term.

Materials and Methods

This is a retrospective cohort study of singleton, non-anomalous fetuses of women with GDM, who primarily had a vaginal delivery attempt. Study inclusion also required no other major fetomaternal abnormalities that make placental dysfunction likely. Data on fetomaternal Doppler sonography including umbilical artery pulsatility index (PI), middle cerebral artery (MCA) PI, cerebroplacental ratio (CPR), mean uterine artery PI, cerebro-placental-uterine ratio (CPUR) was collected from 37+0 weeks on. Multivariate logistic regression analyses were performed using maternal characteristics, neonatal characteristics, and Doppler ultrasound parameters as independent variables with CAPO as a binary outcome.

Results

A total of n=88 cases were included. Nulliparity (p=0.032) and CPUR (p=0.052) were independent predictors of CAPO. However, CPUR had borderline significance. All other Doppler indices were not independent predictors of CAPO. The ability of CPUR alone (AUC=0.65, 95% CI 0.51 to 0.80) to discriminate between GDM pregnancies with and without CAPO was poor.

Conclusion

This study shows that there is no significant clinical relationship between fetomaternal Doppler indices and CAPO among pregnancies with GDM. This raises the question regarding the extent to which fetomaternal Doppler indices, which reflect placental function, can be helpful for CAPO prediction in GDM pregnancies.

Keywords

fetomaternal Doppler - cerebroplacental ratio - uterine artery Doppler - adverse perinatal outcome - gestational diabetes mellitus


Publication History

Received: 19 October 2023

Accepted after revision: 25 February 2025

Article published online:
29 April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Bibliographical Record
Oliver Graupner, Caroline Rath, Linda Lecker, Jochen Ritgen, Bernhard Haller, Christian Enzensberger. Fetomaternal Doppler sonography for the prediction of perinatal outcome in term pregnancies complicated by gestational diabetes mellitus: does it have potential?. Ultrasound Int Open 2025; 11: a25540806.
DOI: 10.1055/a-2554-0806
 

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