To study the changes of maternal spiral artery Doppler indices in women with gestational diabetes in the first trimester of pregnancy.

We performed a prospective observational cohort study, involving 154 singleton pregnancies in our obstetric clinic from December 2016 to February 2018. According to the follow-up results, 138 cases were divided into a normal group and 16 cases were divided into a GDM group. All pregnant women were examined by Doppler ultrasonography at 11-13^{+ 6} weeks of gestation to measure the hemodynamic parameters of the uterine spiral artery, including pulsation index (PI), mean diastolic blood flow velocity (MDV), and time-averaged peak flow velocity (TAPV). The hemodynamic parameters of the GDM group and normal group were compared, and ROC curve analysis was performed to evaluate the effect of uterine spiral artery PI in predicting GDM.

PI of the uterine spiral artery in the GDM group was significantly higher than that in the normal group (0.87±0.34 vs 0.64±0.18, t=-4.06, P<0.05), and MDV and TAPV in the GDM group were slightly lower than those in the normal group, without statistical significance. The area under the ROC curve of PI in predicting GDM was 0.737 (95% CI: 0.606~0.867, P<0.05). Using an optimal cutoff of PI of 0.70, the sensitivity and specificity were 93.8% and 45.8%, respectively.

The hemodynamic changes of the uterine spiral arteryat 11-13^{+ 6} weeks of gestation may be related to the occurrence of GDM. The PI of the uterine spiral artery has appreciated value in predicting GDM.