Correlation of umbilical coiling index and hba1c in gestational diabetes mellitus (one-step strategy).

Laily Najafi,1,* Mohammad e. khamseh,2 Mojtaba malek,3 Azadeh abedini,4 Maryam kadivar,5

1. Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences
2. Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences
3. Research Center for prevention of cardiovascular disease, Institute of Endocrinology and Metabolism, Iran University
4. Kamali Teaching hospital, Alborz University of Medical sciences
5. Department of Pathology, Hazrat-e- Rasool Akram General hospital, Iran University of Medical Sciences

Abstract

Introduction

Gestational diabetes mellitus [gdm] is a prevalent and potentially serious condition which may put mothers and fetuses at risk.so early diagnosis and screening is crucial to prevent complications.coiling is a unique and obvious feature of the human umbilical cord. ultrasonography evaluation of the umbilical coiling index [uci] could predict abnormal coiling index as a routine screening modality.uci is probably one of the most frequently reported umbilical cord related parameters in high risk pregnancies and fetal complications.so this study was performed to evaluate the relationship between hba1c and umbilical coiling index in gdm.

Methods

In this prospective study,117 parturients with diagnosis of gdm were recruited. the diagnosis was confirmed by usage of one-step strategy at 24-28 weeks of gestation. the venous sampling for hba1c was performed at 37-41 weeks of gestation. an anatomical ultrasound survey of placenta and umbilical cord performed at 18-23 and 37-41 weeks of gestation. the umbilical cord coiling was quantitatively assessed using uci. also the uci was evaluated postnatally. a postnatal uci as reference standard was evaluated macroscopically within 24 hours after delivery.

Results

In antenatal and postnatal, the median(quartil1-3) of the uci were as follows:18-23 weeks(0.25(0.17,34)),37-41 weeks(0.21(0.19,0.31)),and postnatal(0.18(0.14,0.36)) respectively. the mean of hba1c was 6.03±0.41. a significant (but weak) relationship was detected between uci value of 18-23 weeks and hba1c(p=0.002,r=0.29). no significant relationship was found between uci value of 37-41 weeks and hba1c(p=0.15,r=0.12). no significant relationship was found between postnatal uci and hba1c(p=0.41,r=0.08).

Conclusion

No significant relationship was detected between hba1c and antenatal uci evaluations of 37-41 weeks. also no significant relationship was detected between hba1c and uci of postnatal evaluation. but a weak significant relationship was discovered between uci value of 18-23 weeks and hba1c.

Keywords

Uci,hba1c,gdm