الفهرس 
Gestational Diabetes MellitusOnly 14 pages are availabe for public view
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Abstract
Abstract
Background: GDM is an important pregnancy disease, because of its possible fetal and maternal complications. Besides the standard biometric measurements, some other fetal body dimensions such as the anterior abdominal wall thickness, skinfold thickness, adipose tissue thickness, Wharton’s jelly thickness, fetal liver length and fetal liver volume (FLV) have been evaluated as ultrasound parameters of glycemic control. While the evaluation of fetal liver dimensions has a role in identifying fetal growth acceleration, previous studies addressed patients with insulin-dependent diabetes mellitus rather than gestational diabetes mellitus, utilized two-dimensional ultrasound and did not argue the diagnostic value of these findings.
Objective: This study was aimed to Compar the fetal liver volume by three-dimensional ultrasound for predication of gestational diabetes mellitus (GDM) with oral glucose tolerance test (2h 75 g OGTT) during the second-trimester (24-28) weeks of gestation Subjects and methods: All the study participants were subjected to all needed workup to make sure they met the inclusion criteria of the current study then they were investigated by recent mean of screening for GDM ‘50-gram one-hour glucose screen’ and FLV measurement by 3D ultrasound. When test result was positive (1hpg ≥140 mg/dL or FLV ≥ 32.72 cm3), the confirmatory test with a 2h 75 g Oral Glucose Tolerance Test was done. The normal cut-off values for the test are: 92, 180 and 153 mg/dl (corresponding to fasting, 1h, and 2hs after glucose overload, respectively). Two changed values exceeding the thresholds are enough for GDM diagnosis. Results: We found that FLV was significantly high in patients with GDM compared to those with healthy pregnancies as observed in correlation with 75g glucose tolerance test “FPG (p <0.001), 1 Hour Glucose (p <0.008) and 2 Hour Glucose (p <0.001)” .The cut off value of fetal liver volume for prediction of GDM which was >42 cm3, with sensitivity of 90.1%, specificity of 80%, positive predictive value of 81.4% and negative predictive value of 91% with diagnostic accuracy of 86.9%. Conclusion: the FLV measurements during the mid-trimester ultrasound scanning may be a tool for the prediction of GDM in the obstetric population.