usg measurement of umbilical cord thickness interventricular septal thickness fetal fat layer prediction of fetal macrosomia in gdm

Abstract

Gestational diabetes is one of the most common diseases newlineduring pregnancy where there is a development of spontaneous newlinehyperglycaemia [1]. International Diabetes Federation states that newlineabout 14% of pregnancies are complicated by GDM [2] which newlineaccounts for about 18million births every year and is expected to newlinehave a drastic increase due to an increase in obesity of women in newlinechildbearing age group. newlineThe associated risk factors associated are Increased BMI newline(Overweight, Obesity), advanced maternal age, family history of newlinediabetes and/or insulin resistance, deficiency of micronutrients and newlinewesternised diet. newlineAlthough GDM is believed to resolve after delivery, there are newlinesome serious long term complications associated which mainly newlineincludes an increased risk of mate rnal cardiovascular diseases, long newlineterm risk of developing Type 2 diabetes mellitus, macrosomia and newlinebirth complications in infants. newlineMacrosomia is a defined as a birth weight of more than 4kg or newlinegreater than 90th percentile for the gestational age when correlated newlinewith ethnicity. Infant of diabetic mothers are more prone to be newlinemacrosomic because of increased association of fetal newlineI N T R O D U C T I O N newline2 newlinehyperglycemia, fetal hyper insulinemia ultimately leading to newlineincreased utilization of glucose and hence an abnormal increase in newlinegrowth. newlineIt leads to potentially life threatening complications to both newlinemother and fetus such as shoulder dystocia, brachial plexus injuries, newlineskeletal injuries in fetus, increased risk of operative vaginal newlinedelivery, third or fourth degree perineal tear and p ostpartum newlinehaemorrhage. newlineHence it is prudent to have an effective screening modality newlinethat predicts macrosomia and steps are taken to provide a modified newlineintrapartum care. The necessity of anticipating macrosomia helps newlinethe obstetrician to choose patients for caesarean section to avoid the newlinematernal and fetal risk occurring due to traumatic delivery and for newlinethe need for a vigilant intrapartum management. newlineThe detection of macrosomia has many pitfalls. The newlinetraditi