Antepartum CTG in euglycemic diabetic pregnancies: A matched control study

Objective: To evaluate the effect of maternal glycemic levels on computeriz ed cardiotocography (cCTG) parameters respect to a matched control group an d to assess how single parameters may vary with changing maternal glycemia. Methods: cCTG recordings of nineteen euglycemic diabetic patients with bioc hemically diagnosed diabetes (according to National Diabetes Data Group) an d the same number of physiological pregnancies matched for maternal age, ge nder and gestational age; were recruited from January 1999 to May 2000. Car diotocograms were recorded by means of an Oxford Sonicaid System 8002 compu terized fetal heart rate (FHR) equipment. We considered only FHR tracings g reater than or equal to 40 min with plasmatic glycemia evaluation at the mi ddle of FHR recording. Results: We observed a significant difference in maternal plasmatic glycemi c levels between diabetic and control group during cCTG analysis (p <0.001) . There were no significant differences between cases and controls for all cCTG parameters tested (FHR, LTV, STV, Acc10, Acc15, HV msec, LV msec and F M/h). Correlating values of plasmatic glycemia with cCTG parameters in case s and controls with the aim to evaluate the effect of maternal glycemia on FHR trace parameters, we observed: in the control group a negative correlat ion between Acc10 (accelerations > 10 bpm) and Acc15 (accelerations > 15 bp m) and glycemic levels (r= -0.51, P <0.019 and r = -0.56, p <0.009), while in the euglycemic diabetic group a negative correlation between episodes HV msec and glycemic levels was found (r = -0.52, p <0.01). Comment: We have observed that in third trimester euglycemic diabetic pregn ancies, FHR parameters evaluated by means of a computerized system seem not to be different from those of a control group. In euglycemic diabetic preg nancies, to increased glycemic levels correspond less episodes of HV msec. In normal pregnancies, to increased glycemic levels correspond less number of Acc 10 and Acc 15.