ABSTRACT
Background: The offspring of women with gestational diabetes mellitus [GDM] are prone to macrosomia. However, birth weight is difficult to be correctly estimated by ultrasound because of fetal asymmetric growth characteristics. This study aimed at investigating the correlations between fetal hemodynamics, fetal growth indices in late pregnancy and birth weight in GDM
Methods: A total of 180 women with GDM and 180 normal controls [NC] with singleton gestation and presented between 38-40 weeks gestation were enrolled in this study. Fetal hemodynamic indices, including the systolic/diastolic ratio [S/D], resistance index [RI], pulsatility index [PI] of umbilical artery [UA], middle cerebral artery [MCA], and renal artery [RA], were collected. Fetal growth indices, including biparietal diameter [BPD], head circumference [HC], abdominal circumference [AC], and femur length [FL], were also measured by ultrasound. Birth weight, mode of delivery and need for Neonatal ICU admission data were collected
Results: The independent samples t-test showed that BPD, HC, AC and FL were larger in GDM than in NC [P < 0.05]. Birth weight was higher in GDM than in NC [P < 0.001]. Among all included women, there was a highly statistically insignificant difference between GDM and NC groups as regard all ultrasound indices including UA_S/D, UA_RI, UA_PI, MCA_S/D, MCA_RI, MCA_PI, RA_S/D, RA_RI and RA_PI [P>0.05]. Pearson's correlation analysis showed in GDM group that there was a highly statistically significant negative correlation between birth weight and the following ultrasound indices: [UA_RI, UA_S/D, UA_PI, MCA_RI and MCA_PI] and that there was a statistically significant positive correlation between birth weight and RA_RI [P<0.01] [r = -0.273, -0.453, -0.537, -0.237, -0.265 and 0.169 respectively, P < 0.05], but As regard NC group there was a highly statistically significant negative correlation between birth weight and the following ultrasound indices: [UA_S/D, UA_RI, UA_PI and MCA_PI] [r = 0.148, -0.360, -0.252 and -0.184 respectively, P < 0.05] but no correlation was found with any of renal artery indices [P > 0.05]
Conclusions: Fetal hemodynamic indices in late pregnancy might be helpful for estimating newborn birth weight in women with GDM
ABSTRACT
Amniotic fluid index was measured in 100 primigravidae women, in labour, medically free end having single viable cephalic fetus. They are classified into two groups. Group 1 included 30 women with intact membranes and group 2 included 70 women with ruptured membranes.The mean AFI was 12.3 +/- 1.2 in group 1 and 5.1 +/- 1.3 in group 2. There was highly significant difference between AFI and meconium grading Apgar scores at one and five minutes and PH values of the cord blood in both groups [P< 0.001]. The AFI values were classified into 4 groups [group A, B, C and D]. There was highly significant difference as regards AFI values between group 1 and group 2. The AFI value has no significant relationship to the gestational ages in both groups [1 and 2], but had a significant relationship to meconium grading. Apgar scores at one and five minutes and PH value of the cord blood. The intrapartum AFI value below which neoborn is at increased risk of fetal distress, is 9 cms in women with ruptured membranes during labour. So the assessment of intrapartum AFI is a comprehensive admission test with the other fetal distress tests