Prediction of fetal growth restriction using combined fetal biometry and maternal serum [Inhibin A] in pregnant women with type 1 diabetes | ||||
Journal of Recent Advances in Medicine | ||||
Article 1, Volume 3, Issue 1, January 2022, Page 1-9 PDF (1009.9 K) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/jram.2021.58444.1109 | ||||
View on SCiNiTO | ||||
Authors | ||||
Hebatalah A Hassan 1; Lamia M Yosri2; Ehsan H Ali2 | ||||
1Gynecology and Obstetrics Department, Suez General Hospital, Egypt. | ||||
2Gynecology and Obstetrics Department, Faculty of Medicine for Girls, Cairo, Al-Azhar University, Egypt. | ||||
Abstract | ||||
Background: Fetal growth restriction is a main contributing factor of perinatal morbidity and mortality. Screening for fetal growth restriction is a major component of prenatal care but it is known to be problematic. One approach to create evolution is to convalesce screening by emerging new sensitive and specific test. Objective: To detect the predictive value of using combined fetal biometry and maternal serum inhibin A in fetal growth restriction detection, in type 1 diabetic patients. Methodology: A prospective cohort study on 100 type1 diabetic pregnant women. At Gestational age after12 weeks, Singleton pregnancy, age 20-40 years. For all patients Serial fetal ultrasound biometry was done and umbilical artery Doppler study were performed, fasting glucose serum levels, Hemoglobin A1C , Maternal Serum Inhibin A were also assessed. Results: Incidence of IUGR was [66%] in a group of cases with high maternal serum Inhibin A level and non-IUGR was [34%] in a group of cases with normal maternal serum Inhibin A level. Receiver operator characteristics [ROC] curves were constructed for serum inhibin A level, pulsitility index PI of umbilical artery UA by average visit and resuscitative index RI of umbilical artery UA by average visit as predictors of intrauterine growth restriction IUGR in included women. It shows that, pulsitility index of umbilical artery PIUA by average visit and serum inhibin A level the most significant predictors. Serum inhibin A level Cut-off >240, Sensitivity 86.8%, Specificity 76.5%, Accuracy 85.8%, pulsitility index of umbilical artery PIUA by Average visit Cut-off >1.39, Sensitivity 92.4% ,Specificity 91.2% Accuracy 89.3%, resuscitative index of umbilical artery RI UA by Average visit Cut-off >0.62, Sensitivity 69.7% ,Specificity 61.8% Accuracy 68.4% . Conclusion: In type 1 diabetic women serum levels of inhibin A, and umbilical artery pulsitility index were highly significantly increased in a status of fetal growth restriction. measurement of maternal serum inhibin A ,in type 1 diabetic pregnant women is reliable as a single test for diagnosis of fetal growth restriction. | ||||
Keywords | ||||
Diabetes; fetal biometry; fetal growth restriction; inhibin A | ||||
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