THE USE OF ULTRASOUND IN THE PREDICTION OF FETAL COMPLICATIONS AMONG DIABETIC PATIENTS IN LATE PREGNANCY | ||||
| Journal of Environmental Science | ||||
| Article 1, Volume 49, Issue 1, January 2020, Page 21-42 PDF (599.35 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/jes.2020.150450 | ||||
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| Authors | ||||
| Hanan A. El-Sherbiny* 1; Hala I. Awad Allah2; Alaa El-Din A. El-Guindy3 | ||||
| 1Boulak El-Dakrour General Hospital | ||||
| 2Institute of Environmental Studies and Research, Ain Shams University | ||||
| 3Faculty of Medicine, Ain Shams University | ||||
| Abstract | ||||
Background: Diabetes mellitus, one of the most common medical complications, has become a major challenging threat in a pregnant woman. It is associated with various maternal and fetal complications which include polyhydramnios, macrosomia, operative interference, shoulder dystocia, birth injuries and perinatal mortality. Effective treatment of pre-existing as well as gestational diabetes mellitus and early prediction of fatal complications will improve outcome and reduce perinatal mortality. Aim of the study: Evaluate the effect of diabetes mellitus on fetal outcome. Assess role of ultrasound in prediction of fetal complications in late diabetic pregnancy using sonographic fetal parameters. Compare between diabetic and non-diabetic regarding ultrasonographic fetal measurements and occurrence of maternal and fetal complications. Patients and Methods: A prospective study including 82 women with diabetic pregnancy (diabetic group) and 156 pregnant women with normal GTT were included in this study and considered as control group. It was conducted in Boulak El-Dakrour General Hospital over a period of 2 years. Women in both groups were subjected to ultrasonographic examination at 27-28 weeks of gestation and at 36-37 weeks. At each examination fetal anthroprometric parameters, umbilical cord thickness and hemodynamic parameters of umbilical artery were measured. Results: of the present study revealed that: There was significant difference between diabetic and control groups regarding sonographic predictors of fetal macrosomia in term of abdominal circumference, estimated fetal body weight and Wharton's jelly area. Fetuses of mothers in the diabetic group showed statistically significant increase of fetal macrosomia, low birth weight and intrauterine fetal demise in comparison to the control group; the diabetic group showed statistically significant increase of cesarean delivery in comparison to the control group. Conclusion: The results of the present study suggest the possibility of using sonographically determined fetal abdominal circumference, Wharton's jelly area, estimated fetal body weight measurements to distinguish women at high risk for abnormal fetal growth and disproportion potentially resulting in early detection and reducing fetal morbidity. In addition, these parameters can be considered as an effective, noninvasive and cost-effective method that can prove useful for evaluating the fetal consequences of maternal hyperglycemia. | ||||
| Keywords | ||||
| Ultrasound; prediction of fetal complications; diabetic patients; late pregnancy | ||||
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