低风险孕妇口服75克糖耐量试验不影响胎儿心脏多普勒参数

Aydin Ocal
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摘要

本研究旨在探讨由75克口服葡萄糖耐量试验(OGTT)引起的急性高血糖是否会对健康低风险妊娠的胎儿心脏产生可通过胎儿心脏多普勒超声检测到的不良影响。在妊娠24至28周期间接受75 g OGTT的健康低风险孕妇被认为是合格的,在测试期间,她们在禁食和1小时和2小时时间点用胎儿超声检查。研究结果包括脐动脉脉搏指数、子宫动脉、胎儿心率、大脑中动脉(MCA)收缩峰值速度(MCA- psv)、MCA脉搏指数、胎儿心脏多普勒参数包括心肌功能指数、左等容收缩舒张时间、k指数、充盈时间、二尖瓣E波和A波速度、E/A比。对53例未患妊娠期糖尿病的妇女进行统计分析。OGTT三个时间点间各多普勒参数比较,差异均无统计学意义(p>0.05)。OGTT空腹时测得的中位MCA-PSV显著高于OGTT第1小时和第2小时测得的值[28(22-42)比26(18-39)和26 (18-38)];术中,0.05]。这种增加与其他研究参数无关(p>0.05)。总体而言,除了MCA-PSV异常外,75 g OGTT不会影响健康孕妇的胎儿心脏多普勒参数。本研究结果可以为临床医生减少低风险妊娠妇女对妊娠糖尿病筛查的犹豫提供重要支持。
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75-g oral glucose tolerance testing does not affect fetal cardiac doppler parameters in low-risk pregnant women
The study aimed to examine whether acute hyperglycemia, caused by the 75-g oral glucose tolerance test (OGTT) can produce fetal cardiac adverse effects that are detectable with fetal cardiac Doppler ultrasound in healthy low-risk pregnancies. Healthy low-risk pregnant women who underwent 75-g OGTT during the gestational period of 24 to 28 weeks were considered eligible and during the test, they were examined with fetal ultrasound at the fasting and 1- and 2-h timepoints. The study findings included the parameters of umbilical artery pulsatility index, uterine artery, fetal heart rate, middle cerebral artery (MCA) peak systolic velocity (MCA-PSV), MCA pulsatility index, and fetal cardiac Doppler parameters including myocardial performance index, left isovolumetric contraction and relaxation times, K-index, filling time, mitral E- and A-wave velocities, and E/A ratio. The data of 53 women without gestational diabetes mellitus were used for statistical analyses. There was no statistical significance among the three-time points of OGTT regarding all the Doppler parameters (p>0.05). The median MCA-PSV measured at the fasting of OGTT was significantly higher than the values measured at the first and second hour of OGTT [28 (22-42) vs. 26 (18-39) and 26 (18-38), respectively; p<0.05]. This increase provided no relationship with other study parameters (p>0.05). Overall, 75-g OGTT does not affect fetal cardiac Doppler parameters in healthy pregnant women except for abnormal findings of MCA-PSV. The results of the current study can provide significant support to clinicians in reducing the hesitations of women with low-risk pregnancies regarding gestational diabetes screening.
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