Diagnostic Accuracy of Fetal Anterior Abdominal Wall Thickness as an Early Sonographic Sign for Diagnosing Gestational Diabetes

Muhammad Sharjeel Sabir; Muhammad Mujeeb Hassan; Moeena Malik; Rabia Saleem; Zartasha Tariq; Khurram Zohaib; Maham Javaid; Adnan Younas Malik; Amna Saleem

doi:10.7759/cureus.46538

Diagnostic Accuracy of Fetal Anterior Abdominal Wall Thickness as an Early Sonographic Sign for Diagnosing Gestational Diabetes

Cureus. 2023 Oct 5;15(10):e46538. doi: 10.7759/cureus.46538. eCollection 2023 Oct.

Authors

Muhammad Sharjeel Sabir¹, Muhammad Mujeeb Hassan², Moeena Malik², Rabia Saleem³, Zartasha Tariq⁴, Khurram Zohaib⁵, Maham Javaid⁶, Adnan Younas Malik⁷, Amna Saleem⁸

Affiliations

¹ Radiology, Holy Family Hospital Rawalpindi, Rawalpindi, PAK.
² Internal Medicine, Rawalpindi Medical University, Rawalpindi, PAK.
³ Obstetrics and Gynecology, Rawalpindi Medical University, Rawalpindi, PAK.
⁴ General Medicine, Holy Family Hospital Rawalpindi, Rawalpindi, PAK.
⁵ Internal Medicine, Benazir Bhutto Hospital, Rawalpindi, PAK.
⁶ Internal Medicine, Allama Iqbal Medical College, Lahore, PAK.
⁷ Internal Medicine and Nephrology, District Headquarter Hospital, Rawalpindi, PAK.
⁸ Pediatrics and Child Health, Islamic International Medical College Trust (IIMCT)Pakistan Railways Hospital, Rawalpindi, PAK.

Abstract

Introduction Traditionally, different fetal variable measurements are used in ultrasound to assess fetal growth. Ultrasound can detect abnormal fetal growth. Gestational diabetes mellitus (GDM) is linked to higher fetal obesity as early as 20 weeks of pregnancy. The amount of fetal adipose tissue may be measured by measuring the thickness of the anterior abdominal wall. Measuring the thickness of the fetus's anterior abdominal wall (AAWT) is a straightforward procedure that may be performed alongside standard abdominal circumference measurements. Objectives To check the diagnostic accuracy of fetal AAWT as an early sonographic sign for diagnosing GDM, keeping oral glucose tolerance test as the gold standard. Study design This research was conducted using a cross-sectional analysis. Study place and duration The study was conducted in the Radiology Department at Rawalpindi Medical University and Allied Hospitals from July 10, 2019 to January 9, 2020. Materials and methods Women between the ages of 18 and 45 who had a family history of type 2 diabetes and were at risk for developing GDM were recruited. Exclusions were made for diabetic women, those carrying multiples, and those with autoimmune diseases. The AAWT measurement of the fetus, which included the skin and subcutaneous tissue, was acquired using the traditional anterior cranial view, 2-3 cm lateral to cord insertion. Pregnant patients at risk for GDM underwent screening using an oral glucose tolerance test. Those exhibiting any two abnormal values were diagnosed with GDM. Results The overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of fetal AAWT as an early sonographic sign for diagnosing GDM, with the oral glucose tolerance test as the gold standard, were 93.14%, 82.65%, 84.82%, 92.05%, and 88.0%, respectively. Conclusion The study concludes that the diagnostic accuracy of fetal AAWT as an early sonographic indicator for identifying gestational diabetes is notably high.

Keywords: body mass index: bmi; diabetes gestational; fetal macrosomia; fetal ultrasound; pregnant females.