Objective: to evaluate the Ramathibodi score in predicting the maternal and perinatal outcomes in pregestational diabetes
Study design: Prospective study was performed in 200 pregestational diabetes pregnant women by evaluating the uterine and umbilical artery Doppler velocimetry at 28 weeks’gestation. The umbilical artery flow spectrum was divided into three scores (UmAS) while the uterine artery Doppler flow spectrum was divided into five uterine artery scores (UtAS). Ramathibodi score (RS) was calculated by adding the UmAS with UtAS.
The perinatal and maternal outcomes were studied.
Results: The mean mother age was 34.18+ 4.32 years. There were 152 (76 %) normal labour, 10 (5 %) forceps delivery, 15 (7.5 %) vacuum delivery and 23 (11.5 %)caesarean section. The mean gestational age at the last examination was 36.12+1.99 completed weeks (range 28-39 weeks) and at delivery 37.18+ 2.19 weeks (range 30-40 weeks). The mean fetal weight was 2,889.95 + 646.63 grammes. The mean gravida was 2.23 + 1.13.DM type 1 and type 2 were found 20% and 80% respectively.The insulin was required in 40% of cases.
RS had the predicting capacity in adverse perinatal outcomes including small for gestational age, low APGAR score, intrauterine fetal death, neonatal intensive care unit admission and also in adverse maternal outcome including preeclampsia.
Conclusion: The RS can predict the adverse perinatal and maternal outcomes in GDM better than either UmAS or UtAS alone.