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Poster session II Clinical obstetrics, diabetes, labor, medical-surgical-disease, physiology/endocrinology, prematurity: Abstracts 237 - 386| Volume 208, ISSUE 1, SUPPLEMENT , S115, January 01, 2013

251: Prediction of macrosomia in pregnancies with pre-gestational diabetes with serial fetal sonographic measurements of soft tissues and liver

      Objective

      To determine if measuring fetal subcutaneous fat and liver antenatally using ultrasound can predict macrosomia in pregnancies with pre-gestational diabetes.

      Study Design

      We performed a prospective study in a level III university center. 29 pregnant women with pre-gestational diabetes were included. Fetal biometry, subcutaneous fat tissue thickness (anterior abdominal wall, thigh, upper arm and scapula) and liver size were sonographically evaluated at 23, 28, 31 and 34 weeks of gestation. Large for gestational age (LGA) was defined as birthweight >90th percentile of customized standards adjusted for maternal height and weight, parity, fetal gender, and gestational age. Areas (+/− standard error) of receiver operating characteristic (ROC) curves were calculated. P <0.05 was considered statistically significant.

      Results

      775 measurements were performed. 15 newborns were LGA. Fetal subcutaneous fat thickness (FSCFT) was not different at 23, 28 and 31 weeks between the macrosomic and non-macrosomic groups. In contrast, at 34 weeks, fetal soft tissues were significantly thicker for LGA newborns (P<0.05, table). Specificity and sensibility to detect macrosomia by a 34-week ultrasonography were respectively 78.6 and 66.7% for abdominal circumference, 71.4 and 93.3% for thigh FSCFT, 85.7 and 80.0% for upper arm FSCFT and, 71.4 and 86.7% for abdominal wall FSCFT. Any parameter was more powerful than the others. The best areas under ROC were found for abdominal circumference (=0.807), thigh FSCFT (=0.821), upper arm FSCFT (=0.855) and abdominal wall FSCFT (=0.821).
      Tabled 1
      Table thumbnail grr12

      Conclusion

      3rd trimester sonographic measurements of soft tissue may help to detect macrosomia in pregnancies with pre-gestational diabetes.