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. 2024 Apr 29;14(5):480.
doi: 10.3390/jpm14050480.

Fetal Splenic Artery Pulsatility Index May Predict the Need for Neonatal Intensive Care in Gestational Diabetes Class A1 Cases

Mehmet Albayrak  1 , Humeyra Akbas  1 , Emine Seda Guvendag Guven  1 , Suleyman Guven  1
Affiliations

Fetal Splenic Artery Pulsatility Index May Predict the Need for Neonatal Intensive Care in Gestational Diabetes Class A1 Cases

Mehmet Albayrak et al. J Pers Med. .

Abstract

The fetal splenic artery pulsatility index is a parameter that reflects fetal well-being and has been used as a predictor of adverse pregnancy outcomes. The aim of this study was to investigate the predictive value of the splenic artery pulsatility index in gestational diabetes mellitus class A1 cases for intensive care unit admission. In this prospective case-controlled study, only sixty single pregnancy cases diagnosed with gestational diabetes mellitus class A1 were evaluated. Fetal splenic artery Doppler parameters such as peak systolic velocity, pulsatility index, resistivity index, and end-diastolic velocity were measured in all cases. The rate of requirements for the neonatal intensive care unit was noted. In cases requiring fetal intensive care, the fetal splenic pulsatility index was found to be statistically significantly lower than in healthy cases without it (0.94 ± 0.29 vs. 1.70 ± 0.53, respectively, p < 0.001, Student's t-test). When the fetal splenic PI cutoff value was selected as 1.105 cm3, the sensitivity was calculated as 97.9% and the specificity as 58.3% for predicting the need for fetal intensive care (AUC 0.968, p < 0.001, 95% CI 0.929-0.998). The use of a low fetal splenic artery PI parameter is a significant and good indicator for predicting the need for fetal intensive care according to the binary logistic regression analysis result (p = 0.006). This study suggests that evaluation of fetal splenic artery Doppler in mothers with gestational diabetes mellitus may be used to predict neonates requiring a newborn intensive care unit. Therefore, it is recommended that obstetricians use this simple, rapid, and valuable evaluation of fetal splenic artery Doppler and alert the neonatologist that a newborn intensive care unit may be required.

Keywords: gestational diabetes; neonatal intensive care unit; prenatal sonography; splenic artery Doppler.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1
Figure 1
Two-dimensional ultrasonographic imaging of the 30-week-old fetus shows the fetal spleen (SP) and splenic artery (SA).
Figure 2
Figure 2
Two-dimensional ultrasonographic imaging in the axial plane of the 30-week-old fetus shows the origin of the fetal splenic artery from truncus coeliacus (TC; truncus coeliacus, AO; aorta, SA; splenic artery, SP; fetal spleen).
Figure 3
Figure 3
Two-dimensional ultrasonographic imaging of the 30-week-old fetus shows pulsed Doppler waveforms of the splenic artery.
Figure 4
Figure 4
Receiver operating curve analysis data showing the relationship between the calculated fetal splenic artery PI value and the need for neonatal intensive care are presented.
See this image and copyright information in PMC

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References

    1. Be M. Hyperglycemia and adverse pregnancy outcomes. N. Engl. J. Med. 2008;358:1991–2002. - PubMed
    1. Rudland V.L., Price S.A., Hughes R., Barrett H.L., Lagstrom J., Porter C., Britten F.L., Glastras S., Fulcher I., Wein P. ADIPS 2020 guideline for pre-existing diabetes and pregnancy. Aust. N. Z. J. Obstet. Gynaecol. 2020;60:E18–E52. doi: 10.1111/ajo.13265. - DOI - PubMed
    1. Brennan S., Kandasamy Y., Rudd D.M., Schneider M.E., Jones R.E., Watson D.L. The effect of diabetes during pregnancy on fetal renal parenchymal growth. J. Nephrol. 2020;33:1079–1089. doi: 10.1007/s40620-020-00815-z. - DOI - PubMed
    1. Gibbons A., Flatley C., Kumar S. Cerebroplacental ratio in pregnancies complicated by gestational diabetes mellitus. Ultrasound Obstet. Gynecol. 2017;50:200–206. doi: 10.1002/uog.17242. - DOI - PubMed
    1. Liu F., Liu Y., Lai Y.-P., Gu X.-N., Liu D.-M., Yang M. Fetal hemodynamics and fetal growth indices by ultrasound in late pregnancy and birth weight in gestational diabetes mellitus. Chin. Med. J. 2016;129:2109–2114. doi: 10.4103/0366-6999.189057. - DOI - PMC - PubMed