Article Text

PO-0439 Evaluation Of The Cerebral Blood Flow In Children With Perinatal Cns Damage Born By Women With Diabetes Mellitus According To Data Of Transcranial Doppler Scanning
  1. AA Afonin1,
  2. AY Babiyants1,
  3. NA Drukker2
  1. 1Pediatric Department, Rostov Scientific-Research Institute of Obstetrics and Pediatrics, Rostov-on-Don, Russia
  2. 2Department of Medical-Biological Problems, Rostov Scientific-Research Institute of Obstetrics and Pediatrics, Rostov-on-Don, Russia

Abstract

Background The leading position in the structure of high perinatal morbidity of children born by women with diabetes mellitus (DM) is taken by the perinatal damage of CNS. It is known that in pathogenesis of hypoxic-ischaemic damages of CNS in newborns the dominant role is assigned to vascular disorders.

Aim To study of indices of the cerebral hemodynamics in such children.

Methods 105 full-term children born by women with DM were examined: mothers of 55 children had DM of type 1, mothers of 50 children had gestational DM (GDM). The control group was comprised of 17 healthy children born by women with physiological pregnancy and delivery. The cerebral blood flow was evaluated by means of Doppler scanning of medial cerebral and anterior cerebral arteries, deep veins of Rozenthal circle (vein of Galen and basal veins of brain) using ultrasonographs. The children were examined and observed in dynamics during one year (in the early neonatal period in 1, 3, 6, 9 and 12 months of life).

Results The perinatal CNS damage was diagnosed in all children both born by women with DM of type 1 and with GDM. In the majority of children neurological symptoms remained by the end of the first year of life despite of the provided treatment. The analysis of dynamics of the cerebral blood flow indices in medial cerebral and anterior cerebral arteries circulation showed the stable increase of resistance index during the whole period of observation as compared with the control values in the observed children (p < 0.02). Doppler scanning of deep intracranial collectors during the first year of life in children born by women with DM of type 1 and with GDM showed the persistent increase in relation to the control of outflow intensity in the vein of Galen (p < 0.001) and basal veins of Rozenthal (p < 0.0001).

Conclusions All children both born by women with diabetes mellitus of type 1 and with gestational diabetes mellitus have prolonged retained symptoms of the cerebral arteriovenous dysfunction, and it shall be considered with the purpose of optimisation of the pathogenetic therapy in such children.

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