Análise crítica dos métodos de avaliação da vitalidade fetal na gestação complicada por diabetes: uma revisão narrativa

Abstract

Objective: To understand how diabetes affects fetal well-being and analyze the main methods of assessing fetal well-being to reduce the risks of fetal mortality and complications. Methods: Descriptive literature review. The bibliographic research was conducted in the PubMed/Medline and Scientific Electronic Library Online (SciELO) databases, using the Health Sciences Descriptors (DeCS) "Pregnancy," "Diabetes," and "Fetal surveillance" combined with the boolean operator "AND," both in English and Portuguese, within the period from 2002 to 2022. Results: A total of 4765 articles were found in PubMed and Scielo databases. Out of these, 11 articles were included in this study. Cardiotocography, fetal biophysical profile examination, echocardiography, and Doppler velocimetry were evaluated, but there was no literature consensus on their use. However, experts recommend the use of all these exams for diabetic pregnant women. Conclusions: The literature still lacks concrete evidence to define the best protocol for assessing fetal well-being in these pregnancies. Further in-depth studies are needed on this topic, especially prospective multicenter studies thatallow comparison of methods and their impact on fetal morbidity and mortality in this frequent gestational complication