Research Of Placental Three-Dimensional Power Doppler Indices In The Third Trimesters Of Pregnancy Complicated By Gestational Diabetes Mellitus

Objective:To investigate the characteristics of placental perfusion in the third trimesters of pregnancy with gestational diabetes mellitus(GDM)and its clinical value,we used three-dimensional power Doppler(3DPD)to measure the relative index of degree of placental vascularization.Methods:63 pregnant women with normal ultrasonic examination and clinical diagnosis of gestational diabetes mellitus were selected as GDM group.And 30 pregnant women with normal prenatal supersonic inspection and without other complications were served as control group.All of pregnant women did prenatal ultrasonography in the First Affiliated Hospital of Guangxi Medical University from March 2018 to January 2019.The ratio of systolic peak velocity to diastolic peak velocity(S/D),resistance index(RI)and pulsatility index(PI)of fetal umbilical artery were measured by conventional two-dimensional ultrasound.After that,using 3DPD ultrasonography to measure the value of placental vascular index(VI),blood flow index(FI)and vascularization flow index(VFI),the data on age,gestational age,the level of blood glucose in Oral Glucose Tolerance Test(Fasting blood glucose,1 hour blood sugar,2 hours blood sugar),pre-pregnancy BMI,gestational age of delivery,neonatal birth weight and pregnancy outcomes were collected at the same time.Results:1.Age,gestational age,pre-pregnancy BMI,delivery age and neonatal birth weight weren’t different significantly between GDM group and control group(P>0.05).2.VI,FI and VFI in the GDM group were significantly lower than the control group(P<0.05).3.There were no different significantly in S/D,PI and RI of umbilical artery blood flow between GDM group and control group(P>0.05).4.Placental indices including VI,FI and VFI were correlated with the level of blood glucose in OGTT(fasting,1 hour,2 hours)and pre-pregnancy BMI(P<0.05),which were significantly negative correlation between them(r_s were respectively VI:r_s=-0.264、r_s=-0.357、r_s=-0.408、r_s=-0.382,FI:r_s=-0.246、r_s=-0.211、r_s=-0.335、r_s=-0.329,VFI:r_s=-0.285、r_s=-0.381、r_s=-0.440、r_s=-0.424).Conclusion:1.The degree of placental vascularization in GDM group was lower than that in control group.The higher of the blood glucose level in OGTT and pre-pregnancy BMI,the lower degree of placental vascularization.2 The changes of intraplacental vascular in GDM group was occurred earlier than the changes of umbilical hemodynamic.3.In evaluating placental blood perfusion,using 3DPD ultrasonography to detect the degree of placental vascularization was superior to using two-dimensional ultrasonography to detect the parameters of fetal umbilical artery blood flow in pregnant women with GDM.We could earlier to understand the situation of fetal hypoxia through 3DPD ultrasonography to detect the degree of fetal placental vascularization.And we could also provide the basis for the clinical formulation of appropriate treatment measures as soon as possible.