Evaluation of Foetal Abdominal Circumference in Pregnancies Affected by Gestational Diabetes Mellitus

Abstract

India is widely known as the diabetic capital of the world. The current prevalence of diabetes represents only the tip of the iceberg of its real problem statement. Gestational diabetes mellitus has many maternal and foetal implications. Early screening, diagnosis and intervention can help prevent many of this complications thus reducing maternal and foetal morbidity. Ultrasonography is one of the easiest, most feasible, non-invasive and safest diagnostic tool which can be used to evaluate patients with gestational diabetes mellitus. The objective of the study was to evaluate foetal abdominal circumference measured sonographically between 28-34 weeks of gestation in patients with gestational diabetes and its association with perinatal outcome and also to study the association of glycaemic control with birth weight in patients with gestational diabetes mellitus. METHODS A single ultrasound examination was done between 28-34 weeks of gestation in 65 selected and well dated patients who satisfied the inclusion and exclusion criteria. The patients were classified into 2 groups with one group having foetal abdominal circumference ≤75 th percentile and the other having foetal abdominal circumference >75 th percentile. The patients were followed up till delivery and perinatal outcome and birth weight was noted. RESULTS Relevant statistical analysis was done to find out the association of foetal abdominal circumference with perinatal outcome. 73.9% of Large for gestational age infants had foetal abdominal circumference >75 th percentile. 77.7% of neonates who had Apgar score <7 at 5 minutes after delivery had foetal abdominal circumference >75 th percentile. All the neonates with hypoglycaemia and prematurity and 60% of neonates with hyperbilirubinemia and 85% of neonates with acute respiratory distress syndrome had foetal abdominal circumference >75 th percentile. All the patients with poor glycaemic control had large for gestational age babies and 77.7% had foetal abdominal circumference >75 th percentile. CONCLUSION This study showed that foetal abdominal circumference >75 th percentile was associated with higher birth weight and poor perinatal outcome. It also concluded that poor maternal glycaemic control is associated with higher foetal abdominal circumference and birth weight and hence poor perinatal outcome.