Comparison of "Glucose loading tests" done between weeks 24.-28 of pregnancy with the first trimester uterine artery doppler

Introduction: To determine the diagnosis of GDM or the risk of GDM in the first trimester with Doppler USG, a non-invasive method for early diagnosis of GDM, with a 50% probability of developing DM within ten years after a complicated pregnancy in 4% of all pregnancies was used. Methods: Between November 2020 and February 2022, pregnancies of 11 weeks to 13 weeks and 6 days, who applied directly to the Gynecology and Obstetrics polyclinics of Aydın Adnan Menderes University Hospital were evaluated as a consultation from other clinics with UtA Doppler values recorded in the hospital automation system or in the USG devices of our clinic. A total of 76 singleton pregnancies were included. Pregnant women with pregestational DM and multiple pregnancies were excluded from the study. UtA Doppler evaluation was evaluated as transabdominal or transvaginal. With real-time color Doppler USG imaging, the cervical canal was visualized in the sagittal plane and the vascular bundle around the cervix was visualized by moving the USG transducer to the right or left lateral. After visualizing the UtA at the level of the internal cervical os, the UtA trace was measured before giving the UtA arcuate artery branches. While measuring, after the insonation angle was set to <300, the sample spacing was set to 2 mm and three consecutive wavelengths were printed. UtA was confirmed by measuring the peak systolic velocity (PSV) above 60 cm/s. Then, similarly, Doppler measurement of UtA on the contralateral side was performed. The arithmetic means of the PI values of both right and left UtAs measured was calculated and recorded. Mean UtA PI values were converted to Multiple of Median (MoM) which were determined by The Fetal Medicine Foundation (FMF). GDM screening in pregnancy at 24 to 28 weeks of gestation, either two-stage or one-stage testing is recommended. In our study, a blood glucose level of 140 mg/dL and above in the 50 g OGTT, which is the first step of the two-stage test, was taken as the threshold value. Diabetes screening of pregnant women included in the study was left to their own will. OGTT results were obtained from the hospital system or by calling the patients by phone. Results: Seventy six singleton pregnant women were included in the study. Three pregnant women who did not want to have diabetes screening and three pregnant women who could not be reached were excluded from the study, so, 68 pregnant women were included in the study. There was no pregnancy resulting in abortion or premature birth. 12 (17.64%) pregnant women were diagnosed with GDM after OGTT results. It was observed that the UtA Doppler PI MoM values of the pregnant women grouped by age (p:0.097) and the pregnant women who were diagnosed with GDM (p:0.684) and those who did not (p:0.070) were independent of age. No statistical significance was found between UtA PI MoM values (p:0132) according to BMI and normoglycemic pregnant women who were diagnosed with GDM (p:0.667) and were not diagnosed with GDM (p:0.15). It was observed that there was no relationship between the UtA Doppler PI MoM value (p:0.609) and the pregnant women diagnosed with GDM (p:0.122) and those who did not (p:0.935) according to the fertility status of the pregnant women. There was no statistical correlation between the UtA Doppler PI MoM value (p:0.907) and the pregnant women who were diagnosed with GDM (p:0.371) and those who were not diagnosed with GDM (p:0.651) and having an additional disease or risk factor. There was no correlation between the UtA Doppler PI MoM value (p:0.609) and the pregnant women diagnosed with GDM (p:0.122) and the undiagnosed pregnant women (p:0.935). Conclusion: UtA Doppler USG PI MoM values measured in the first trimester were not found to be correlated with parameters such as age, BMI, fertility status, presence of additional disease and whether or not the pregnant woman was diagnosed with GDM. Key Words: UtA Doppler, GDM, First Trimester