A study on comparison of non-stress test and Doppler velocimetry in assessment of fetal well-being in gestational diabetes mellitus

Abstract

Background: Non-stress test (NST) and Doppler velocimetry are established tools for fetal surveillance. In gestational diabetes mellitus (GDM), a high risk pregnancy condition, antenatal monitoring is crucial to optimize perinatal outcomes. Aims and Objectives: This study aimed to compare the efficacy of NST and Doppler velocimetry in predicting perinatal outcomes in GDM mothers. Materials and Methods: This prospective observational study was conducted at R.G. Kar Medical College from January 2019 to June 2020. A total of 160 consecutive GDM mothers between 32 and 40 weeks of gestation with singleton pregnancies, excluding pre-GDM and gestational hypertension, were assessed weekly with NST and Doppler studies. The last test results before delivery were analyzed. Neonatal outcomes included APGAR score at 5 min, respiratory distress syndrome, serum glucose and calcium levels, and neonatal intensive care unit stay duration. Results: Abnormal Doppler parameters were observed in 15.63% and non-reactive NST in 25% of mothers. Poor perinatal outcomes occurred in 51 (31.88%) cases, most frequently APGAR <7 at 5 min (37.25%) and hypoglycemia (35.29%). Normal vaginal delivery was most common overall (43.75%), whereas lower segment cesarean section due to fetal distress predominated in poor outcome cases (45.1%). Non-reactive NST was significantly associated with adverse outcomes (P<0.001). Doppler findings showed no significant association (P=0.342). Sensitivity and specificity of NST were 52.94% and 88.07%, respectively, compared to 19.6% and 86.23% for Doppler. Conclusion: NST was superior to Doppler Velocimetry in predicting fetal compromise among GDM mothers, highlighting its value in antenatal surveillance.