The effect of 50 GR oral glucose tolerance test on fetal celiac artery and superior mesenteric artery Doppler parameters in healthy pregnancies

Gokcen Orgul; Ayse Ceren Duymus; Yasin Altekin; Ahmet Yanar; Nizamettin Bozbay; Cetin Celik

doi:10.1515/jpm-2023-0168

Article

The effect of 50 GR oral glucose tolerance test on fetal celiac artery and superior mesenteric artery Doppler parameters in healthy pregnancies

Gokcen Orgul , Ayse Ceren Duymus , Yasin Altekin , Ahmet Yanar , Nizamettin Bozbay and Cetin Celik

Published/Copyright: July 25, 2023

Published by

Become an author with De Gruyter Brill

Submit Manuscript Author Information Explore this Subject

From the journal Journal of Perinatal Medicine Volume 51 Issue 9

Abstract

Objectives

To understand the effect of 50-g oral glucose tolerance test (OGTT) on fetal celiac artery and superior mesenteric artery (SMA) Doppler parameters.

Methods

A total of 43 healthy pregnant women followed in our hospital were included in the study. All Doppler parameters of the celiac artery and SMA (peak systolic velocity (PSV); pulsatility index (PI); resistance index (RI); systolic/diastolic ratio (SD); time average maximum velocity (TAMAX)) were obtained by ultrasonography before and 1 h after OGTT.

Results

The mean PSV value of the celiac artery decreased statistically significantly after OGTT (37.29 ± 11.96 cm/s; 29.51 ± 10.07 cm/s; p=0.002). While the mean of the PI was 2.09 ± 0.57 before the test, it was found to be 1.84 ± 0.64 after the test (p=0.027). Mean PSV (39.82 ± 13.07 cm/s; 35.19 ± 15.27 cm/s; p=0.104) and PI (2.21 ± 0.65; 2.11 ± 0.80; p=0.375) values of SMA were also found to be decreased without statistically significancy.

Conclusions

The data obtained from our study reveals that the PSV and PI values of celiac artery and SMA slightly decrease after OGTT.

Keywords: coeliac artery; gestational diabetes mellitus; oral glucose tolerance test; superior mesenteric artery; ultrasonography

Corresponding author: Gokcen Orgul, Division of Perinatology, Department of Obstetrics and Gynecology, Faculty of Medicine, Selcuk University, Konya, Türkiye, Phone: +905556066254, E-mail: gokcenorgul@gmail.com

Funding source: Selcuk University Research Foundation

Research funding: This study was supported by Selcuk University Scientific Research Projects with project number 21301009.
Author contributions: GO found the study idea and contributed to the conceptualization, design, data collection, data analysis, and initial draft of the manuscript. ACD, YA,AY and NB contributed to data collection, analysis, and manuscript writing. CC supervised and contributed to the conceptualization and editing of the manuscript. All the authors have read and approved the final version of the manuscript.
Conflict of interest: The authors have no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: All procedures performed in our study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Selcuk University Faculty of Medicine Ethics Committee approved the study protocol with the decision number 2021/363.

References

1. McIntyre, HD, Catalano, P, Zhang, C, Desoye, G, Mathiesen, ER, Damm, P. Gestational diabetes mellitus. Nat Rev Dis Prim 2019;5:1–19. https://doi.org/10.1038/s41572-019-0098-8.Search in Google Scholar PubMed

2. Mertoglu, C, Gunay, M, Gungor, M, Kulhan, M, Kulhan, NG. A study of inflammatory markers in gestational diabetes mellitus. Gynecol Obstet Reproduct Med 2019;25:7–11. https://doi.org/10.21613/gorm.2018.775.Search in Google Scholar

3. Hanna, F, Peters, J. Screening for gestational diabetes; past, present and future. Diabet Med 2002;19:351–8. https://doi.org/10.1046/j.1464-5491.2002.00684.x.Search in Google Scholar PubMed

4. Bakanlığı TCS. Doğum öncesi? bakim yöneti?m rehberi? 2018.Search in Google Scholar

5. Fadiloglu, E, Tanacan, A, Unal, C, Hakli, DA, Beksac, MS. Clinical importance of the 75 g glucose tolerance test (GTT) in the prediction of large for gestational age (LGA) fetuses in non-diabetic pregnancies. J Perinat Med 2019;47:534–8. https://doi.org/10.1515/jpm-2018-0373.Search in Google Scholar PubMed

6. Pan, FC, Brissova, M. Pancreas development in humans. Curr Opin Endocrinol Diabetes Obes 2014;21:77. https://doi.org/10.1097/med.0000000000000047.Search in Google Scholar PubMed PubMed Central

7. Persson, B, editor. Neonatal glucose metabolism in offspring of mothers with varying degrees of hyperglycemia during pregnancy. In: Seminars in fetal and neonatal medicine. Stockholm, Sweden: Elsevier; 2009. https://doi.org/10.1016/j.siny.2009.01.003.Search in Google Scholar PubMed

8. Aydın, GA, Akdur, PÖ, Özgen, G. The effect of glucose tolerance test on fetoplacental circulation. Taiwan J Obstet Gynecol 2021;60:723–7. https://doi.org/10.1016/j.tjog.2021.05.024.Search in Google Scholar PubMed

9. Gillis, S, Connors, G, Potts, P, Hunse, C, Richardson, B. The effect of glucose on Doppler flow velocity waveforms and heart rate pattern in the human fetus. Early Hum Dev 1992;30:1–10. https://doi.org/10.1016/0378-3782(92)90081-q.Search in Google Scholar PubMed

10. Pardo, J, Orvieto, R, Rabinerson, D, Bar, J, Hod, M, Kaplan, B. Fetal middle-cerebral and umbilical artery flow assessments after glucose challenge test. Int J Gynecol Obstet 1999;65:255–9. https://doi.org/10.1016/s0020-7292(99)00026-0.Search in Google Scholar PubMed

11. Yogev, Y, Ben‐Haroush, A, Chen, R, Hod, M, Merril, Z, Meizner, I. Doppler sonographic characteristics of umbilical and uterine arteries during oral glucose tolerance testing in healthy pregnant women. J Clin Ultrasound 2003;31:461–4. https://doi.org/10.1002/jcu.10202.Search in Google Scholar PubMed

12. Ayaz, R, Günay, T, Yardımcı, OD, Turgut, A, Ankaralı, H. The effect of 75 g oral glucose tolerance test on maternal and foetal Doppler parameters in healthy pregnancies: a cross-sectional observational study. J Obstet Gynaecol 2021;41:83–8. https://doi.org/10.1080/01443615.2020.1849072.Search in Google Scholar PubMed

13. Donatini, B. A systematic study of the vascularisation of the pancreas. Surg Radiol Anat 1990;12:173–80. https://doi.org/10.1007/bf01624519.Search in Google Scholar

14. Ebbing, C, Rasmussen, S, Godfrey, K, Hanson, M, Kiserud, T. Fetal celiac and splenic artery flow velocity and pulsatility index: longitudinal reference ranges and evidence for vasodilation at a low portocaval pressure gradient. Ultrasound Obstet Gynecol 2008;32:663–72. https://doi.org/10.1002/uog.6145.Search in Google Scholar PubMed

15. Weissman, A, Goldstick, O, Geva, A, Zimmer, EZ. Computerized analysis of fetal heart rate indices during oral glucose tolerance test. J Perinat Med 2003;31:302–6. https://doi.org/10.1515/JPM.2003.042.Search in Google Scholar PubMed

16. Haugen, G, Bollerslev, J, Henriksen, T. Human umbilical and fetal cerebral blood flow velocity waveforms following maternal glucose loading: a cross‐sectional observational study. Acta Obstet Gynecol Scand 2016;95:683–9. https://doi.org/10.1111/aogs.12913.Search in Google Scholar PubMed

17. Guleroglu, FY, Ozmen, AB, Bakirci, IT, Dogu, SY, Yılmaz, I, Cetin, A. Fetal pancreas size and maternal serum biomarkers glycated albumin and insulin-regulated aminopeptidase provide no potential for early prediction of gestational diabetes mellitus. Arch Gynecol Obstet 2022:1–10. https://doi.org/10.1007/s00404-022-06860-2.Search in Google Scholar PubMed PubMed Central

18. Golbasi, H, Bayraktar, B, Golbasi, C, Omeroglu, I, Adiyaman, D, Sever, B, et al.. Can sonographic imaging of the fetal pancreas predict perinatal outcomes in gestational diabetes mellitus? J Perinat Med 2022;50:1189–97. https://doi.org/10.1515/jpm-2022-0050.Search in Google Scholar PubMed

19. Gilboa, Y, Krekora, M, Perlman, S, Bardin, R, Kassif, E, Achiron, R, et al.. Sonographic measurement of the fetal pancreas in women with gestational diabetes. Arch Med Sci 2022;18:382. https://doi.org/10.5114/aoms/140578.Search in Google Scholar PubMed PubMed Central

20. Akkaya, H, Büke, B, Uysal, G. Fetal pancreatic hyperechogenicity may be an early ultrasonographic sign of gestational diabetes mellitus. J Matern Fetal Neonatal Med 2020;33:2387–94. https://doi.org/10.1080/14767058.2018.1551351.Search in Google Scholar PubMed

21. Bertelli, E, Di Gregorio, F, Bertelli, L, Mosca, S. The arterial blood supply of the pancreas: a review. Surg Radiol Anat 1995;17:97–106. https://doi.org/10.1007/bf01627566.Search in Google Scholar PubMed

22. Korszun, P, Dubiel, M, Breborowicz, G, Danska, A, Gudmundsson, S. Fetal superior mesenteric artery blood flow velocimetry in normal and high-risk pregnancy. J Perinat Med 2002;30:235–41. https://doi.org/10.1515/JPM.2002.033.Search in Google Scholar PubMed

23. Velipasaoğlu, M, Surmeli Onay, O, Saglık, AC, Aydemir, O, Tanır, HM, Tekin, AN. The relationship of foetal superior mesenteric artery blood flow and the time to first meconium passage in newborns with late-onset foetal growth restriction. J Obstet Gynaecol 2022;42:1978–83. https://doi.org/10.1080/01443615.2022.2056830.Search in Google Scholar PubMed

24. Matasova, K, Dokus, K, Zubor, P, Danko, J, Zibolen, M. Physiological changes in blood flow velocities in the superior mesenteric and coeliac artery in healthy term fetuses and newborns during perinatal period. J Matern Fetal Neonatal Med 2011;24:827–32. https://doi.org/10.3109/14767058.2010.531316.Search in Google Scholar PubMed

Received: 2023-04-19

Accepted: 2023-06-11

Published Online: 2023-07-25

Published in Print: 2023-11-27

You are currently not able to access this content.

Articles in the same Issue

https://doi.org/10.1515/jpm-2023-0168

Keywords for this article

coeliac artery; gestational diabetes mellitus; oral glucose tolerance test; superior mesenteric artery; ultrasonography