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Journal of Health Sciences and Medicine

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Original Article
Ultrasonographic evaluation of Caval Aortic Index in gestational and pregestational diabetes: a predictor of perinatal outcomes?
Abstract
Aims: Diabetes mellitus (DM), including gestational (GDM) and pregestational diabetes (pre-GDM), adversely affects maternal and fetal outcomes due to hyperglycemia and vascular changes. The Caval Aortic Index, a non-invasive measure of blood volume, could provide insights into these complications. In our study, we aimed to determine the functional changes in inferior vena cava (IVC) and aorta (Ao) diameters as well as the importance of caval aortic index in predicting perinatal outcomes in diabetic pregnant women.
Methods: This prospective case-control study included 120 DM patients and 100 controls. DM patients were divided into pre-GDM, diet-regulated GDM, and insulin-regulated GDM groups. Ultrasound measurements of inferior vena cava and aortic diameters were performed, alongside Doppler evaluations. Statistical analyses were conducted to assess the association of these parameters with adverse perinatal outcomes.
Results: Although the IVC and aortic diameters of the pregnant women with DM were higher compared to the control group and a statistically significant difference (p<0.001) was found between the groups, the Caval-Aortic Index was similar between the groups. Adverse outcomes (APGAR 5 min <7, need for mechanical ventilation, need for continued positive airway pressure, respiratory distress syndrome, transient tachypnea of the newborn and neonatal intensive care unit admission and neonatal low cord blood pH) were higher in DM groups but showed no direct correlation with IVC or aortic parameters. IVC diameter was the most predictive parameter in DM patients and the cut-off was >3.81 mm (AUC: 0.674).
Conclusion: Ultrasonographic IVC and aortic diameters reflect vascular adaptations in diabetic pregnancies but lack predictive value for adverse outcomes. While the Caval Aortic Index provides limited prognostic utility, integrating these measurements into comprehensive models may enhance perinatal risk assessment.

Keywords : Gestational diabetes, pregestational diabetes, Caval Aortic Index, perinatal outcomes, ultrasonography, vascular adaptations

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Article available in :
Volume 8, Issue 2, 2025
Page : 254-261
https://doi.org/10.32322/jhsm.1616423
Article Information
Received : 09 Oca 2025
Accepted : 06 Şub 2025
Published : 21 Mar 2025
Corresponding Author :

Gülşan Karabay: Department of Perinatology, Ankara Etlik City Hospital, Ankara, Turkiye

[email protected]
Citation : Karabay G, Şeyhanlı Z, Filiz AA, et al. Ultrasonographic evaluation of Caval Aortic Index in gestational and pregestational diabetes: a predictor of perinatal outcomes? J Health Sci Med. 2025;8(2):254-261.

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