DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20181945

Prospective study on sonographic measurement of umbilical cord thickness, foetal fat layer, interventricular septal thickness as predictors of macrosomia in fetus of women with gestational diabetes mellitus

Janani N., Vimala D., Gayathri N.

Abstract


Background: The objectives of the study were to evaluate the Prediction of foetal macrosomia based on sonographic measurements of foetal fat layer, Interventricular septal thickness and umbilical cord thickness in Gestational Diabetes Mellitus at term.

Methods: After assessment of inclusion and exclusion criteria 100 antenatal women of gestational age more than 37 weeks selected for study in the Department of Obstetrics and Gynaecology of Vinayaka Mission’s Kirupananda variyar medical college and hospital, Salem. Participants underwent a third trimester scan and three extra measurements i.e. Umbilical cord thickness, Interventricular septal thickness and foetal fat layer are measured in addition to the normal examination.

Results: In present study umbilical cord thickness had good sensitivity and negative predictive value. Hence, if umbilical cord thickness is less than 90th centile the chance of macrosomia is less, the cut off of foetal fat layer ≥5 mm as predictor of macrosomia had sensitivity of 84.2% and specificity of 86.4% and cut off of Interventricular septal thickness ≥3.9mm as a predictor of macrosomia had sensitivity of 84.2%, specificity of 64.2%, negative predictive value of 95.9%. Thus, interventricular septal thickness and foetal fat layer is a reliable predictor of macrosomia.

Conclusions: From this study authors concluded that Umbilical cord thickness, foetal fat layer and Interventricular septal thickness are good predictors of foetal macrosomia. In the assessment of risk of macrosomia in addition to the ultrasonographic measurements the clinical risk factors must be considered.


Keywords


Foetal fat layer, Interventricular septal thickness, Macrosomia, Umbilical cord thickness

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References


Wild S, Roglic G, Green A, King H. Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care. 2004 May;27(5):1047-53.

Ian Donald's Practical Obstetric problems. seventh ed. Diabetes. 2014;7:127.

Spellacy WN, Miller S, Winegar A, Peterson PQ. Macrosomia maternal characteristics and infant complications. Obstet Gynecol. 1985;66:158-61.

Ferber A. Maternal complications of fetal macrosomia. Clin Obstet Gynecol. 2000;43:335-9.

Hadlock FP, Harrist RB, Sharman RS, Deter RL, Park SK. Estimation of fetal weight with the use of head, body and femur measurements. A prospective study. Am J Obstet Gynecol. 1985;151:333-7.

Brans YW, Shannon DL, Hunter MA. Maternal diabetes and neonatal macrosomia. II. Neonatal anthropometric measurements Early Hum Dev. 1983; 8:297-305.

Cromi A, Ghezzi F, Di Naro E, Siesto G, Bergamini V, Raio L. Large cross‐sectional area of the umbilical cord as a predictor of fetal macrosomia. Ultrasound Obstet Gynecol. 2007 Nov;30(6):861-6.

Bethune M, Bell R. Evaluation of the measurement of the fetal fat layer, interventricular septum and abdominal circumference percentile in the prediction of macrosomia in pregnancies affected by gestational diabetes. Ultrasound Obstet Gynecol. 2003;22:586-90.

Tian C, Hu C, He X, Zhu M, Qin F, Liu Y, Hu C. Excessive weight gain during pregnancy and risk of macrosomia: a meta-analysis. Arch Gynecol Obstet. 2016 Jan;293(1):29-35.

Karim SA, Mastoor M, Ahmed AJ. Macrosomia: maternal and fetal outcome. Asia Oceania J Obstet Gynaecol. 1994;20(1):73-6.