الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Diabetes mellitus complicating pregnancy is one of the most common antenatal complications that are associated with significant perinatal mortality and morbidity.
Effective management of pre-existing as well as gestational diabetes mellitus was shown to improve outcome and reduce perinatal mortality, as compared to untreated patients.
A lot of emphasis has been put on fetal surveillance in these high-risk pregnancies in the attempt to optimise pregnancy outcome. There is, however, no consensus as to the best methods of antepartum surveillance.
The use of Doppler studies of the umbilical and middle cerebral arteries have been demonstrated to reduce perinatal adverse outcome in non-diabetic pregnancies, but their use in diabetic pregnancies have shown conflicting results, and still insufficiently researched.
The objective of this study was to assess the effects of diabetes complicating pregnancy on Doppler parameters of middle cerebral and umbilical arteries and correlating it to the perinatal outcome, wishing to add a solution to the conflict around the value of Doppler in fetal surveillance in diabetes with pregnancy.
The study was conducted on 90 females selected from the antenatal clinic of EL Shatby Maternity University Hospital during the period from August 2014 till October 2015. Those women were divided into 3 groups. group A included 30pregestational diabetes pregnant females group B included 30 gestational diabetes pregnant females. group C included 30 females with normal course pregnancy (control group).
After taking an informed consent from all pregnant ladies involved in the study, they were subjected to complete history taking, clinical examination, screening of all pregnant females agreed to be included in this study with no known history of diabetes was done through 50-g, 1- hour test (O’Sullivan test), then 100-g, 3-hour oral glucose tolerance test (OGTT) for patients with abnormal one hour test.
Pregnant females with known history of diabetes mellitus were assessed for their diabetic state and control through fasting, 2-hour postprandial blood glucose level and HbA1c.
Transabdominal ultrasound examination was done to all pregnant females involved in the study followed by Doppler studies of the Umbilical artery (UA) and Middle cerebral artery (MCA).
All pregnant females involved in the study were followed till delivery to assess perinatal outcome through evaluation of Fetal outcome (Neonatal weight, occurance of birth injuries, 5-minute Apgar score, Admission to NICU (Neonatal intensive care unit), days of admission, intrauterine fetal death and maternal outcome (Mode of delivery, Occurance of complications, e.g: obstructed labour and vaginal tears).
from this study we found that:
There was statistically significant difference among the three groups regarding bad obstetric complications (intra-uterine fetal death, stillbirths), maternal weight, fetal abdominal circumference, estimated fetal weight and amniotic fluid index.