Abstract
Guidelines on the management of gestational diabetes (GDM) instruct physicians to involve ultrasound-based monitoring of fetal growth in addition to blood glucose. So far, glucose control besides clinical parameters like maternal body mass index (BMI) and gestational weight gain have been shown to predict neonatal outcome. We aimed to evaluate the discriminative ability of fetal abdominal subcutaneous tissue (FAST) in addition to standard ultrasound parameters like abdominal circumference (AC) and estimated fetal weight (EFW) for perinatal complications like large for gestational age (LGA), hypoglycemia, hyperbilirubinemia, mode of delivery and admission to neonatal intensive care unit (NICU). Ultrasound data and neonatal outcome was collected of 805 GDM cases from 2012 to 2016: 3205 FAST, 3195 AC-measurements and 3190 EFW calculations were included. AC, EFW and FAST increased linear with gestational age. Combining ultrasound and clinical parameters improved predictive power for LGA. In the subgroup where fetuses grow with an AC > 75th additional adding of FAST to standard ultrasound parameters increased predictive power for hypoglycemia. Our results confirm inclusion of ultrasound parameters to be beneficial in monitoring GDM pregnancies. Additional FAST determination revealed to be of potential clinical relevance in the subgroup AC > 75th percentile.
Highlights
During the last couple of years Ultrasound (US) based monitoring of fetal growth has become more relevant for optimizing treatment of pregnancies affected by gestational diabetes mellitus (GDM)
Adverse perinatal outcomes like newborns being born large for gestational age (LGA), necessity of C-section, neonatal hypoglycemia, hyperbilirubinemia and admission to neonatal intensive care unit (NICU) are still more frequent in pregnancies complicated by GDM [1,2,3,4,5,6]
Our results implicate that measurement of the estimated fetal weight (EFW), abdominal circumference (AC) and fetal abdominal subcutaneous tissue (FAST) are useful parameters to monitor treatment in patients with GDM and help to discriminate those who are going to be LGA at birth
Summary
During the last couple of years Ultrasound (US) based monitoring of fetal growth has become more relevant for optimizing treatment of pregnancies affected by gestational diabetes mellitus (GDM). Several studies on fetal abdominal subcutaneous tissue (FAST) claiming this US parameter to be another noninvasive marker sensitive for the nutritional state of the fetus [8,9,10]. Most of these studies focused on the value of FAST in predicting fetal birth weight and especially LGA newborns. Madendag et al showed that FAST measurements are able to predict LGA newborns with similar performance like AC and EFW [11]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
