Evaluation of maternal and fetal Doppler parameters in women undergoing a 50-g oral glucose challenge test: a cross-sectional observational study

Abstract

BackgroundGlucose challenge tests (GCT) are routinely used to screen for gestational diabetes mellitus (GDM), yet their acute effects on maternal and fetal hemodynamics remain unclear. Understanding these physiological responses is important in the context of increasing patient concern regarding the safety of such tests.AimTo investigate the acute effects of 50 g GCT on maternal and fetal Doppler ultrasound parameters in low-risk, healthy pregnant women.MethodsForty-nine participants between 24 and 28 gestational weeks were included in this prospective study. Doppler ultrasound examinations were performed to assess fetal and placental circulation. The Pulsatility Index (PI), Resistance Index (RI), and PI Z-scores were analyzed for the umbilical artery (UA), uterine artery (UtA), and middle cerebral artery (MCA). The cerebroplacental ratio (CPR) and its Z-score were also analyzed. All measurements were performed at the 0th and 1st hours of the GCT.ResultsThere were no significant changes in fetal MCA-PI, UA-PI, or CPR Z-scores following glucose intake (p > 0.05 for all). However, there was a significant increase in maternal uterine artery PI and RI values at the first hour of the GCT (PI, p = 0.031; RI, p = 0.002). These findings suggest a transient increase in uteroplacental vascular resistance in response to acute hyperglycemia.ConclusionAcute maternal hyperglycemia from the 50-g GCT may alter uterine artery blood flow without significantly affecting fetal Doppler indices. These subtle changes require further investigation, particularly in high-risk pregnancies or metabolic disorders, to inform clinical decisions and patient counseling regarding GCT use.