Ultrasound Diagnosis of Diabetic Fetopathy
Objective of the Study: To improve perinatal outcomes by refining the antenatal diagnosis of diabetic fetopathy (DF) in pregnant women with various types of diabetes mellitus (DM).
Study Design: This was an experimental, single-center, prospective, cohort, controlled study.
Materials and Methods: Six hundred and sixty-eight pregnant women were examined in the study. The main group consisted of 241 patients with verified DM: gestational DM, type 1 DM, or type 2 DM. The control group was made up of 427 pregnant women in whom DM had been ruled out. All participants underwent ultrasound and Doppler scanning. Patients in the main group were divided into two subgroups: women whose infants did not have DF (n = 100) after birth and patients whose newborns were diagnosed with DF (n = 141).
Study Results: Ultrasound diagnosis of DF includes an assessment of macrosomia, fetal proportionality, phenotypic and visceral signs of DF, functional status of the fetus, as evaluated by its hemodynamic parameters, and condition of the structures surrounding the fetus. Analysis of the phenotypic signs of DF showed that an increase in scapular width and thickness of the neck and abdominal subcutaneous tissue of the fetus had the highest diagnostic value for identifying this condition. Among the visceral signs of DF, the most significant were fetal hepatomegaly, cardiomegaly, and cardiomyopathy, and pancreatic enlargement (sensitivity up to 100%). There were statistically significant differences between the DF subgroups, on the one hand, and the control group, on the other, in volumetric blood flow in the umbilical arteries. The high specificity (up to 75.0%) and prognostic value (up to 88.8%) of a negative result mean that it can be used for clarifying the grade of DF.
Conclusion: DF can be suspected in fetuses of mothers either with DM or without verified DM no earlier than at week 16 of gestation. The diagnosis of DF may be suggested by a reduced head circumference/abdominal circumference ratio, thickening of the neck, head and abdominal subcutaneous tissue of the fetus, or cardiomegaly. These parameters are non-specific as to the type of DM, and are the same in women with all types of carbohydrate metabolism disorder.
S.N. Lysenko — Moscow Regional Research Institute of Obstetrics and Gynecology; 22A Pokrovka St., Moscow, Russian Federation 101000. eLIBRARY.RU SPIN: 3442-6268. E-mail: firstname.lastname@example.org
M.A. Chechneva — Moscow Regional Research Institute of Obstetrics and Gynecology; 22A Pokrovka St., Moscow, Russian Federation 101000. eLIBRARY.RU SPIN: 2292-6321. E-mail: email@example.com
V.A. Petrukhin — Moscow Regional Research Institute of Obstetrics and Gynecology; 22A Pokrovka St., Moscow, Russian Federation 101000. eLIBRARY.RU SPIN: 9236-6783. E-mail: firstname.lastname@example.org
F.F. Burumkulova — Moscow Regional Research Institute of Obstetrics and Gynecology; 22A Pokrovka St., Moscow, Russian Federation 101000. eLIBRARY.RU SPIN: 6592-7736. E-mail: email@example.com
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