Effects of hypoglycaemia on fetal heart activity and umbilical artery Doppler velocity waveforms in pregnant women with insulin-dependent diabetes mellitus

• Published in: British journal of obstetrics and gynaecology Vol. 103; no. 5; p. 413
• Main Authors: Björklund, A O, Adamson, U K, Almström, N H, Enocksson, E A, Gennser, G M, Lins, P E, Westgren, L M
• Format: Journal Article
• Language: English
• Published: England 01.05.1996
• Subjects: Adult; Blood Flow Velocity; Female; Heart Rate, Fetal - physiology; Humans; Hypoglycemia - physiopathology; Pregnancy; Pregnancy in Diabetics; Pregnancy Trimester, Third; Pregnancy, High-Risk; Prospective Studies; Ultrasonography, Prenatal; Umbilical Arteries - physiopathology
• ISSN: 0306-5456
• DOI: 10.1111/j.1471-0528.1996.tb09766.x

To study the effect of induced hypoglycaemia on fetal wellbeing as indicated by fetal heart rate and umbilical artery flow velocity waveforms. A prospective experimental investigation. High risk pregnancy unit and diabetes research unit at Karolinska Institutet, Danderyd Hospital, a university affiliated hospital. Ten women with insulin-dependent diabetes mellitus in the third trimester of pregnancy. The fetal heart rate, the blood flow velocity waveforms in the umbilical artery and the maternal catecholamine levels were investigated during a 150-minute hyperinsulinaemic hypoglycaemic clamp with induction and maintenance of an arterial blood glucose level of about 2.2 mmol/l. 1. Fetal: changes of fetal heart rate pattern and pulsatility index of the umbilical artery flow velocity waveforms. 2. Maternal: levels of plasma adrenaline and plasma noradrenaline. Maternal hypoglycaemia was associated with an increase in frequency and amplitude of fetal heart rate accelerations, a slight decrease in the pulsatility index of the umbilical artery and a rise in the maternal catecholamine levels. We speculate that the increased number of fetal heart rate accelerations reflects an increased sympathico-adrenal activity during the hypoglycaemia clamp. No potentially harmful effects on the fetus were observed in the fetal heart rate or in the umbilical artery Doppler waveform analysis during hypoglycaemia.