First‐trimester uterine artery Doppler examination in pregnancies complicated by gestational diabetes mellitus with or without pre‐eclampsia

Objectives To assess first‐trimester placental perfusion, reflected in the uterine artery ( UtA ) pulsatility index ( PI ), in pregnancies complicated by gestational diabetes mellitus ( GDM ), with or without pre‐eclampsia ( PE ), compared with those unaffected by GDM . Methods UtA‐PI was measured at 11 + 0 to 13 + 6 weeks' gestation in 1037 singleton pregnancies that subsequently developed GDM and in 56 649 normoglycemic controls. The measured mean UtA‐PI was converted to multiples of the expected normal median ( MoM ), corrected for maternal weight, racial origin and gestational age, and the median MoM values in the two groups were compared . Results The incidence of PE was higher in pregnancies with GDM than in controls (4.0% vs 2.3%, respectively ; P  =  0.001). However, there were no significant differences in the median UtA‐PI MoM between the groups (1.00 (interquartile range ( IQR ), 0.82–1.21) vs 1.00 ( IQR , 0.81–1.21) ; P  = 0.73). The median UtA‐PI in patients who developed PE was higher than in those who did not develop PE , regardless of the development of GDM . Conclusions First‐trimester placental perfusion, as assessed by UtA Doppler examination, is not impaired in women who subsequently develop GDM . The increased prevalence of PE in women with GDM cannot be attributed to impaired placentation. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd .