The Relevance of Fetal Abdominal Subcutaneous Tissue Recording in Predicting Perinatal Outcome of GDM Pregnancies: A Retrospective Study

Friederike Weschenfelder; Nadin Baum; Thomas Lehmann; Ekkehard Schleußner; Tanja Groten

doi:10.3390/jcm9103375

The Relevance of Fetal Abdominal Subcutaneous Tissue Recording in Predicting Perinatal Outcome of GDM Pregnancies: A Retrospective Study

J Clin Med. 2020 Oct 21;9(10):3375. doi: 10.3390/jcm9103375.

Authors

Friederike Weschenfelder¹, Nadin Baum¹, Thomas Lehmann², Ekkehard Schleußner¹, Tanja Groten¹

Affiliations

¹ Department of Obstetrics, University Hospital Jena, 07747 Jena, Germany.
² Institute of Medical Statistics and Computer Science, University Hospital Jena, Friedrich Schiller University Jena, 07747 Jena, Germany.

Abstract

Guidelines on the management of gestational diabetes (GDM) instruct physicians to involve ultrasound-based monitoring of fetal growth in addition to blood glucose. So far, glucose control besides clinical parameters like maternal body mass index (BMI) and gestational weight gain have been shown to predict neonatal outcome. We aimed to evaluate the discriminative ability of fetal abdominal subcutaneous tissue (FAST) in addition to standard ultrasound parameters like abdominal circumference (AC) and estimated fetal weight (EFW) for perinatal complications like large for gestational age (LGA), hypoglycemia, hyperbilirubinemia, mode of delivery and admission to neonatal intensive care unit (NICU). Ultrasound data and neonatal outcome was collected of 805 GDM cases from 2012 to 2016: 3205 FAST, 3195 AC-measurements and 3190 EFW calculations were included. AC, EFW and FAST increased linear with gestational age. Combining ultrasound and clinical parameters improved predictive power for LGA. In the subgroup where fetuses grow with an AC > 75th additional adding of FAST to standard ultrasound parameters increased predictive power for hypoglycemia. Our results confirm inclusion of ultrasound parameters to be beneficial in monitoring GDM pregnancies. Additional FAST determination revealed to be of potential clinical relevance in the subgroup AC > 75th percentile.

Keywords: estimated fetal weight; fetal abdominal subcutaneous tissue; gestational diabetes; large for gestational age; perinatal complications; ultrasound predictors.