FETAL BIOPHYSICAL ACTIVITIES IN 3RD-TRIMESTER PREGNANCIES COMPLICATEDBY DIABETES-MELLITUS

OBJECTIVE: Our purpose was to compare third-trimester fetal biophysica l activities in normal and well-controlled insulin-dependent diabetic pregnancies. STUDY DESIGN: We performed serial bimonthly fetal biophys ical studies from 30 to 38 weeks in 18 normal and 18 well-controlled i nsulin-dependent diabetic pregnancies (White classes B through D). Eac h study contained 60 minutes of simultaneous ultrasonographic recordin gs of fetal breathing movements and rates, baseline heart rate, and bo dy movements. Mean daily blood glucose levels of diabetic patients wer e determined from home monitors; HbA(1c) was determined every 6 weeks and ultrasonographic fetal growth rates every 3 weeks. Data were compa red with t tests, analysis of variance with repeated measures, and chi (2) tests. RESULTS: Women in the diabetic group maintained good glycem ic control and were delivered of normal infants of weights similar to those of nondiabetic gravidas. Their fetuses had higher mean incidence s of fetal breathing movement, fetal heart rates, and fetal breathing rates but lower fetal movements and fetal heart rate acceleration coun ts than did controls throughout the study, Neither short- nor long-ter m maternal glycemic levels correlated well with fetal biophysical perf ormance. CONCLUSIONS: In spite of good maternal glycemic control fetus es of diabetic women behaved differently from those of nondiabetic wom en. Modulation of their biophysical activities may be affected by mate rnal glycemic status before the last trimester. Different standards mi ght need to be applied to interpret their tests.