UTERINE ARCUATE ARTERY DOPPLER AND DECIDUAL MICROVASCULAR PATHOLOGY IN PREGNANCIES COMPLICATED BY TYPE-I DIABETES-MELLITUS

The objective was to correlate Doppler indices from the uterine arcuat e arteries with an analysis of the decidual vascular histology in pati ents with type I diabetes. Pulsed wave Doppler was used to sample the uterine arcuate artery system beneath the placenta within 8 days of de livery in 47 patients with type I diabetes mellitus. A placental patho logist, without Knowledge of either clinical outcome or Doppler inform ation, classified the histological appearance of the decidual arteries as normal, type A (hyalinization, mural thickening), or type B (fibri noid necrosis, atherosis, thrombosis). Patients were then grouped acco rding to the histology of the decidual arteries. An analysis of varian ce (ANOVA) of the systolic/diastolic (S/D) ratios (log. S/D) showed si gnificant variation (p < 0.025). A multiple range comparison test show ed that patients with normal or only mildly abnormal (type A) vessels had similar values, whereas those with severe vasculopathy (type B) ha d significantly higher S/D ratios (p <0.05). The study confirmed a rel ationship between arcuate artery Doppler indices and downstream decidu al vascular pathology.