Ultrasound Diagnosis of Diabetic Fetopathy

Lysenko, S. N.; Чечнева, М. А.; Petrukhin, V. A.; Burumkulova, F. F.

doi:10.31550/1727-2378-2019-162-7-19-23

Cited by 3 publications

(2 citation statements)

References 3 publications

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“…GDM is the most common disorder of carbohydrate metabolism in obstetric practice, leading to the development of complications during pregnancy, childbirth, and fetal development [11,12]. Pregnant women with GDM have an increased risk of threatened miscarriage, and premature and operative delivery; they have higher risks of developing polyhydramnios and severe preeclampsia [12].…”

Section: Introductionmentioning

confidence: 99%

“…Pregnant women with GDM have an increased risk of threatened miscarriage, and premature and operative delivery; they have higher risks of developing polyhydramnios and severe preeclampsia [12]. Fetal complications include diabetic fetopathy, shoulder dystocia, traumatism during childbirth, severe asphyxia, and cerebrovascular accidents of traumatic origin [11]. In addition, the presence of diabetes mellitus in the mother increases the risk of developing long-term metabolic complications, including obesity and type 2 diabetes mellitus in children [13].…”

Section: Introductionmentioning

confidence: 99%

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Hypothyroidism And Gestational Diabetes Mellitus: Is There A Relationship?

et al. 2022

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Background and Objective — Subclinical gestational hypothyroidism (SGH) and gestational diabetes mellitus (GDM) constitute two most common endocrine pathologies encountered during pregnancy. SGH and GDM have common pathophysiological mechanisms, being interrelated pathological conditions that are capable of complicating the course of pregnancy, labor and the postpartum period both on the part of the mother and on the part of the fetus. We aimed to analyze the relationship between these pathologies and to assess the risk of developing GDM against the background of hypothyroidism. Materials and Methods — the study included 200 pregnant women observed at the Perinatal Center of the Maternity Hospital the Bauman State Clinical Hospital No. 29 during 2018-2020. The main group consisted of 133 women who visited the perinatal center for hypothyroidism (both SGH and primary hypothyroidism, detected prior to pregnancy); the control group comprised 67 women without endocrine pathology. Both groups were comparable in terms of age, height, weight, and the number of pregnancies in the anamneses. The main group received levothyroxine sodium therapy with the achievement of the target trimester-specific level of thyroid-stimulating hormone (TSH). The criteria for the diagnosis of SGH were the TSH level above 2.5 μIU/mL in combination with an enlarged titer of antithyroid antibodies and/or a burdened medical history of thyroid pathology, or the TSH level above 4.0 μIU/mL in the absence of antithyroid antibodies [1]. The diagnosis of GDM was established on the basis of fasting hyperglycemia (≥5.1 mmol/L), or based on the results of an oral glucose tolerance test (OGTT) with 75 g of glucose: fasting glucose level of ≥5.1 mmol/L; the concentration 1 hour after glucose intake ≥10.0 mmol/L; the content 2 hours after glucose intake ≥8.5 mmol/l) [2]. In both groups, the frequency of developing GDM, the timing of diagnosis, and the need for insulin therapy were evaluated. Statistical data processing was carried out using the StatTech v. 2.1.0 software. Quantitative indicators were assessed for compliance with the normal distribution via Shapiro-Wilk criterion or Kolmogorov-Smirnov criterion. Intergroup comparison was performed using Mann-Whitney U test or Pearson’s chi-squared test. Results — We discovered that among women with a burdened family history of thyroid pathology and diabetes mellitus, as well as with thyroid pathology prior to pregnancy, the prevalence of hypothyroidism was higher. The presence of thyroid pathology in the anamnesis of pregnant women was associated with an earlier diagnosis of hypothyroidism. We revealed a significant difference in the prevalence of GDM between two groups of subjects. The chances of detecting GDM in the hypothyroidism group were 8.6 times higher than in the euthyroidism group. The threshold level of TSH for the first trimester, predicting the development of GDM, was identified. The sensitivity and specificity of the model were 71.4% and 63.1%, respectively. Conclusion — Hypofunction of the thyroid and GDM are interrelated endocrine pathologies. In the presence of hypothyroidism (both primary and SGH), GDM develops significantly more often. The level of TSH in the first trimester ≥2.7 μIU/mL amplifies the chance of developing GDM by over 8 times; hence, it could be considered a signal for timely prevention and detection of this pathology.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hypothyroidism And Gestational Diabetes Mellitus: Is There A Relationship?

et al. 2022

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Gestational diabetes mellitus and obesity: effects on offspring

Рожкова

Ремнева

Fadeeva

et al. 2021

Akušerstvo, ginekologiâ i reprodukciâ

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Aim: to identify the risk factors for gestational diabetes mellitus (GDМ) and predictors of perinatal lesions of central nervous system (CNS) combined with GDМ and maternal obesity.Materials and Methods. А retrospective observational case-control non-combined study was conducted to determine GDМ risk factors and their effect on perinatal pathology in 250 women divided into 2 groups. The main group included 150 pregnant women diagnosed with GDМ, the control group – 100 pregnant women without carbohydrate metabolism disorders. An assessment of hereditary, obstetric and gynecological history, as well as somatic health was carried out. Patients from the main group were subdivided into smaller groups: 1А (n = 77) – mothers whose newborns postnatally exerted adverse perinatal outcomes associated with impacting maternal hyperglycemia, and 1В (n = 73) – mothers whose newborns were born healthy. CHAID method (Chi Squared Automatic Interaction Detection) was used to create an algorithm for predicting adverse perinatal outcomes in GDМ. Аt the second stage, a single-center prospective observational non-combined cohort study was conducted to assess an effect of maternal hyperglycemia on formation of perinatal CNS lesions. Pre-labor concentration of neuron-specific enolase (NSE) was measured in the amniotic fluid of full-term fetuses in the group of pregnant women with GDM (n = 33) and in the group of pregnant women lacking carbohydrate metabolism disorders (n = 42).Results. Obesity, late reproductive age, family history of type 2 diabetes mellitus, abortions, early reproductive losses, macrosomic delivery in history are the main risk factors for GDM development. An algorithm was developed that allowed to predict a risk of newborn perinatal pathology in mother with GDM with an overall percentage of correct predictions of 68.7 ± 3.8 %. Pre-labor concentration of NSE in the amniotic fluid of full-term fetuses was elevated by 1.68 times (p = 0.006) in women with combined GDM and obesity (5.56 [3.37–6.24] ng/ml) compared to pregnant women with normal weight lacking carbohydrate metabolism disorders (3.29 [1.49–4.89] ng/ml).Conclusion. Pregnant women with obesity and type 2 diabetes mellitus familial history were featured with most prominent potential of developing perinatal complications. Rise in amniotic fluid NSE level in patients with GDМ corroborates damage of fetal CNS during antenatal period. The maximum NSE level was found in women comorbid with GDM and obesity.

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Course of pregnancy and childbirth in comorbid patients with gestational diabetes mellitus

Жаркин

Zabolotneva

2021

V.F.Snegirev Archives of Obstetrics and Gynecology

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AIM: This study aimed to assess the course of pregnancy and childbirth in comorbid patients with gestational diabetes mellitus (GDM). MATERIALS AND METHODS: This retrospective analysis enrolled 168 individual cards of pregnant women and women in labor with GDM between 2018 and 2020. RESULTS: Analysis of the comorbid background of pregnant women revealed the presence of overweight and obesity in 48.2% of patients. Thus, these conditions were attributed as determinants in the development of GDM. In 58.7% patients, delivery was performed by cesarean section; however, in 11.3% of pregnant women, surgical delivery was performed for the first time; the main indication for it was a large fetus. CONCLUSION: Comorbid background in pregnant women contributes to GDM development, which causes a high percentage of obstetric complications and diabetic fetopathy. The risk strategy for this pathology involves predicting complications using continuous outpatient observation, timely treatment, and hospitalization in accordance with the degree of risk.

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Ultrasound Diagnosis of Diabetic Fetopathy

Cited by 3 publications

References 3 publications

Hypothyroidism And Gestational Diabetes Mellitus: Is There A Relationship?

Hypothyroidism And Gestational Diabetes Mellitus: Is There A Relationship?

Gestational diabetes mellitus and obesity: effects on offspring

Course of pregnancy and childbirth in comorbid patients with gestational diabetes mellitus

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