Circulation favors the placenta more than the brain in fetuses of diabetic mothers.
Blood flows preferably to the placenta instead of the brain in fetuses of mothers with diabetes, according to an investigation presented in Euroching-Imaging 2016, the annual meeting of the European Association of Cardiovascular Images (EACVI), for its acronym in English),A branch of the European Society of Cardiology (ESC), which is held until this Saturday in Leipzig, Germany.
"We know that maternal diabetes mellitus affects the fetal organs," says Dr. Aparana Kulkarni, a pediatric cardiologist at the 'Bronx-Lebanon Hospital Center', in New York, United States."Babies born of mothers with diabetes are sometimes larger, especially if diabetes is not controlled, and the placenta is larger. There are data that suggests that some other organs such as the pancreas and the kidneys in the fetus could be affected", he adds.
The previous investigation of Dr. Kulkarni identified subclinical changes in the heart muscle of mothers fetuses with diabetes.In the study that is now investigated whether these fetuses recorded changes in blood circulation
The investigation included 14 mothers fetuses with type 1 or 2 and 16 fetuses of mothers without diabetes (control group).Nine of the diabetic mothers used insulin, three took oral medications and two used only the diet to control their glucose levels.
The researchers used fetal Doppler echocardiography to measure the blood flow that reaches the brain, the left and right flow of the heart, the aorta and the placenta.The data was connected to a computerized model that mimics the fetal circulation and was developed by Dr. Patricia Garcia-Canadilla, of the Physense Research Laboratory of Dr. Bart Bijnens, from the University of Pompeu Fabra, Barcelona.
less flow to brain arteries
The researchers found that, compared to fetuses in the control group, in the fetuses of diabetic mothers, more blood flowed to the placenta and deviated away from the brain.Specifically, the fetuses of diabetic mothers had lower placental resistance and elasticity, less blood flow to the brain arteries (measured from the radius of the cerebral artery), less blood flow to the brain in front of the placenta and lower cardiac power.
Kulkarni points out: "The computational model equivalent to fetal circulation is an electrical circuit where there are resistances and elasticities. It is easier for blood to flow to the placenta and more difficult to go to the brain."And he adds that the placenta in fetuses of diabetic mothers has changes in their blood vessels and it is known that they are important;Therefore, they probably receive more blood supply.
But it emphasizes that the slightest proportion of blood that is supplied to the brain is an interesting finding and could have major implications."The placenta is eliminated after the baby is born, so it is no longer part of the circulation," he remembers-but it is possible that the reduction of circulation to the brain in the uterus can affect the baby throughoutLife ".
"We do not know enough about why this redistribution of blood flow or the implications it may have. More research is needed to find out if this has any long -term impact on the baby's health and if something can be done to prevent it"He says.
And he concludes: "At present, I do not think that changes in the attention to pregnant women with diabetes mellitus should be made based on these findings. They must continue the standard obstetric recommendations on the strict control of glucose and lead a healthy lifestyle"
