Fetal biophysical activities in third-trimester pregnancies complicated by diabetes mellitus

Lawrence D Devoe, Alaaeldin A. Youssef, Ramon A. Castillo, Christopher S. Croom

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Objective: Our purpose was to compare third-trimester fetal biophysical activities in normal and well-controlled insulin-dependent diabetic pregnancies. Study Design: We performed serial bimonthly fetal biophysical studies from 30 to 38 weeks in 18 normal and 18 well-controlled insulin-dependent diabetic pregnancies (White classes B through D). Each study contained 60 minutes of simultaneous ultrasonographic recordings of fetal breathing movements and rates, baseline heart rate, and body movements. Mean daily blood glucose levels of diabetic patients were determined from home monitors; HbA1c was determined every 6 weeks and ultrasonographic fetal growth rates every 3 weeks. Data were compared with t tests, analysis of variance with repeated measures, and χ2 tests. Results: Women in the diabetic group maintained good glycemic control and were delivered of normal infants of weights similar to those of nondiabetic gravidas. Their fetuses had higher mean incidences of fetal breathing movement, fetal heart rates, and fetal breathing rates but lower fetal movements and fetal heart rate acceleration counts than did controls throughout the study. Neither short- nor long-term maternal glycemic levels correlated well with fetal biophysical performance. Conclusions: In spite of good maternal glycemic control fetuses of diabetic women behaved differently from those of nondiabetic women. Modulation of their biophysical activities may be affected by maternal glycemic status before the last trimester. Different standards might need to be applied to interpret their tests.

Original languageEnglish (US)
Pages (from-to)298-305
Number of pages8
JournalAmerican Journal of Obstetrics and Gynecology
Volume171
Issue number2
DOIs
StatePublished - Jan 1 1994

Keywords

  • Diabetes mellitus
  • biophysical testing
  • fetal breathing
  • fetal heart rate
  • fetal movement

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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