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Mid-trimester ultrasound parameters for predicting birth weight in low risk pregnancies vs high-risk pregnancies complicated with pre-gestational diabetes mellitus
Affiliations- Gynaecology and Obstetrics Ward, Specialist Hospital, Zakopane, Poland
- Department of Reproduction, Poznan University of Medical Sciences, Poznan, Poland
- Prenatal Diagnostic Centre, Gynaecology and Obstetrics Hospital, Poznan University of Medical Sciences, Poznan, Poland
- Chair and Department of Oncology, Poznan University of Medical Sciences, Poznan, Poland
- Department of Obstetrics and Women’s Health, Chair of Gynaecology, Obstetrics and Gynaecological Oncology, Poznan University of Medical Sciences, Poznan, Poland
- Chair and Department of Laboratory Diagnostics, Poznan University of Medical Sciences, Poznan, Poland
open access
Abstract
Objectives: The aim of the study was to assess the utility of mid-trimester ultrasound parameters in predicting birth weight in low-risk pregnancy and high-risk pregnancy complicated with pregestational diabetes mellitus. Material and methods: A study group comprised 97 healthy women and 160 women with pregestational diabetes (PGDM, type 1), all in singleton pregnancy. Ultrasound examination was performed between weeks 11 and 14, and in weeks 20 and 30 of gestation, based on recommendations of the Polish Society of Gynecologists and Obstetricians, Ultrasonography Division. We also checked uterine artery blood flow parameters. Results: There is a correlation between the birth weight and ultrasound-ascertained parameters, including those characterising uterine artery blood flow and foetal biometry [abdominal circumference (AC), femoral length (FL), biparietal dimension (BPD)].The biparietal dimension (BPD), head circumference (HC) abdominal circumference (AC) and pre-existing diabetes are the ultrasound predictors of LGA. The presence of an early-diastolic uterine artery blood flow waveform notching, as well as the uterine artery pulsatility index (UAPI), femoral length (FL) and hypertension in pregnancy are the ultrasound predictors of SGA. In the subset of women with pre-gestational diabetes (PGDM), there is a negative correlation between the birth weight and the uterine artery pulsatility index and early-diastolic uterine artery blood flow waveform notching. In women with pre-gestational diabetes mellitus (PGDM), femoral length (FL) is a significant predictor of LGA and in case of SGA significant predictors are uterine artery pulsatility index, artery blood flow waveform notching and femoral length (FL). Conclusions: Midtrimester ultrasound parameters with confirmed usefulness in the prediction of birth weight in low-risk pregnancy and high-risk pregnancy complicated with pregestational diabetes mellitus include: uterine artery PI, early-diastolic uterine artery blood flow waveform notching and foetal biometry.
Abstract
Objectives: The aim of the study was to assess the utility of mid-trimester ultrasound parameters in predicting birth weight in low-risk pregnancy and high-risk pregnancy complicated with pregestational diabetes mellitus. Material and methods: A study group comprised 97 healthy women and 160 women with pregestational diabetes (PGDM, type 1), all in singleton pregnancy. Ultrasound examination was performed between weeks 11 and 14, and in weeks 20 and 30 of gestation, based on recommendations of the Polish Society of Gynecologists and Obstetricians, Ultrasonography Division. We also checked uterine artery blood flow parameters. Results: There is a correlation between the birth weight and ultrasound-ascertained parameters, including those characterising uterine artery blood flow and foetal biometry [abdominal circumference (AC), femoral length (FL), biparietal dimension (BPD)].The biparietal dimension (BPD), head circumference (HC) abdominal circumference (AC) and pre-existing diabetes are the ultrasound predictors of LGA. The presence of an early-diastolic uterine artery blood flow waveform notching, as well as the uterine artery pulsatility index (UAPI), femoral length (FL) and hypertension in pregnancy are the ultrasound predictors of SGA. In the subset of women with pre-gestational diabetes (PGDM), there is a negative correlation between the birth weight and the uterine artery pulsatility index and early-diastolic uterine artery blood flow waveform notching. In women with pre-gestational diabetes mellitus (PGDM), femoral length (FL) is a significant predictor of LGA and in case of SGA significant predictors are uterine artery pulsatility index, artery blood flow waveform notching and femoral length (FL). Conclusions: Midtrimester ultrasound parameters with confirmed usefulness in the prediction of birth weight in low-risk pregnancy and high-risk pregnancy complicated with pregestational diabetes mellitus include: uterine artery PI, early-diastolic uterine artery blood flow waveform notching and foetal biometry.
Keywords
birth weight; blood flow waveform notching; uterine artery pulsatility index; LGA; SGA
About this articleTitle
Mid-trimester ultrasound parameters for predicting birth weight in low risk pregnancies vs high-risk pregnancies complicated with pre-gestational diabetes mellitus
Journal
Issue
Article type
Research paper
Pages
216-222
Published online
2020-04-29
Page views
1746
Article views/downloads
1096
DOI
Pubmed
Bibliographic record
Ginekol Pol 2020;91(4):216-222.
Keywords
birth weight
blood flow waveform notching
uterine artery pulsatility index
LGA
SGA
Authors
Anna Gasiorowska
Agnieszka Zawiejska
Piotr Dydowicz
Ewa Wender-Ozegowska
Grzegorz Poprawski
Kinga Tobola-Wrobel
Katarzyna Ziolkowska
Marek Pietryga
References (15)- Rekomendacje Polskiego Towarzystwa Ginekologów i Położników dotyczące cięcia cesarskiego. Ginekologia i Perinatologia Praktyczna. 2018; 3(4): 159–174.
- Ropacka-Lesiak M. Wewnątrzmaciczne ograniczenie wzrastania płodu. In: Bręborowicz GH. ed. Położnictwo Tom 2: Medycyna matczyno-płodowa. PZWL, Warszawa 2012: 105–117.
- Bomba-Opoń D. Nieprawidłowe wzrastanie płodu: hipotrofia i hipertrofia. In: Bręborowicz GH. ed. Położnictwo i ginekologia Tom 1: Położnictwo. PZWL, Warszawa 2016: 190–195.
- Szejniuk W, Szymankiewicz M. Makrosomia i inne zaburzenia występujące u no-worodka matki z cukrzycą. Perinatologia, Neonatologia i Ginekologia. 2008; 1: 253–259.
- Campbell S, Diaz-Recansens J, Grifiin D, et al. New Doppler techniqe for assesing uteroplacental blood flow. Lancet. 1983: 675–677.
- Ducey J, Schulman H, Farmakides G, et al. Uterine artery Doppler velocimetry in pregnant women with hypertension. Am J Obstet Gynecol. 1986; 154(4): 806–813.
- Gasiorowska A, Zawiejska A, Dydowicz P, et al. Maternal factors, ultrasound and placental function parameters in early pregnancy as predictors of birth weight in low-risk populations and among patients with pre-gestational diabetes. Ginekol Pol. 2019; 90(7): 388–395.
- Gómez O, Martínez JM, Figueras F, et al. Uterine artery Doppler at 11-14 weeks of gestation to screen for hypertensive disorders and associated complications in an unselected population. Ultrasound Obstet Gynecol. 2005; 26(5): 490–494.
- Pietryga M, Gąsiorowska-Szot A, Wolski H. Badanie dopplerowskie tętnicy macicznej w medycynie perinatalnej. In: Pietryga M, Brązert J. ed. Praktyczna ultrasonografia w położnictwie i ginekologii. Exemplum, Poznań 2012: 527–553.
- Hammami A, Mazer Zumaeta A, Syngelaki A, et al. Ultrasonographic estimation of fetal weight: development of new model and assessment of performance of previous models. Ultrasound Obstet Gynecol. 2018; 52(1): 35–43.
- Frick AP, Syngelaki A, Zheng M, et al. Prediction of large-for-gestational-age neonates: screening by maternal factors and biomarkers in the three trimesters of pregnancy. Ultrasound Obstet Gynecol. 2016; 47(3): 332–339.
- Poon LC, Lesmes C, Gallo DM, et al. Prediction of small-for-gestational-age neonates: screening by biophysical and biochemical markers at 19-24 weeks. Ultrasound Obstet Gynecol. 2015; 46(4): 437–445.
- Lesmes C, Gallo DM, Saiid Y, et al. Prediction of small-for-gestational-age neonates: screening by uterine artery Doppler and mean arterial pressure at 19-24 weeks. Ultrasound Obstet Gynecol. 2015; 46(3): 332–340.
- Familiari A, Bhide A, Morlando M, et al. Mid-pregnancy fetal biometry, uterine artery Doppler indices and maternal demographic characteristics: role in prediction of small-for-gestational-age birth. Acta Obstet Gynecol Scand. 2016; 95(2): 238–244.
- Parry S, Sciscione A, Haas DM, et al. Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be. Role of early second-trimester uterine artery Doppler screening to predict small-for-gestational-age babies in nulliparous women. Am J Obstet Gynecol. 2017; 217(5): 594.e1–594.e10.
