Mid-trimester ultrasound parameters for predicting birth weight in low risk pregnancies vs high-risk pregnancies complicated with pre-gestational diabetes mellitus

Anna Gasiorowska; Agnieszka Zawiejska; Piotr Dydowicz; Ewa Wender-Ożegowska; Grzegorz Poprawski; Kinga Tobola-Wrobel; Katarzyna Ziołkowska; Marek Pietryga

doi:10.5603/GP.2020.0043

Mid-trimester ultrasound parameters for predicting birth weight in low risk pregnancies vs high-risk pregnancies complicated with pre-gestational diabetes mellitus

Ginekol Pol. 2020;91(4):216-222. doi: 10.5603/GP.2020.0043.

Authors

Anna Gasiorowska¹, Agnieszka Zawiejska², Piotr Dydowicz³, Ewa Wender-Ożegowska², Grzegorz Poprawski⁴, Kinga Tobola-Wrobel⁵, Katarzyna Ziołkowska⁶, Marek Pietryga^{3

5}

Affiliations

¹ Gynaecology and Obstetrics Ward, Specialist Hospital, Zakopane, Poland. lepricorn@interia.pl.
² Department of Reproduction, Poznan University of Medical Sciences, Poznan, Poland.
³ Prenatal Diagnostic Centre, Gynaecology and Obstetrics Hospital, Poznan University of Medical Sciences, Poznan, Poland.
⁴ Chair and Department of Oncology, Poznan University of Medical Sciences, Poznan, Poland.
⁵ Department of Obstetrics and Women's Health, Chair of Gynaecology, Obstetrics and Gynaecological Oncology, Poznan University of Medical Sciences, Poznan, Poland.
⁶ Chair and Department of Laboratory Diagnostics, Poznan University of Medical Sciences, Poznan, Poland.

PMID: 32374022
DOI: 10.5603/GP.2020.0043

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: LGA; SGA; birth weight; blood flow waveform notching; uterine artery pulsatility index.

MeSH terms

Adult
Birth Weight
Case-Control Studies
Diabetes, Gestational / diagnostic imaging*
Female
Humans
Pregnancy
Pregnancy Complications / diagnostic imaging
Pregnancy Trimester, Second
Pregnancy in Diabetics / diagnostic imaging*
Pregnancy, High-Risk*
Ultrasonography, Prenatal / methods
Uterine Artery / diagnostic imaging*