Can sonographic imaging of the fetal pancreas predict perinatal outcomes in gestational diabetes mellitus?

Abstract

Objectives To evaluate whether fetal pancreatic echogenicity and its measurements are associated with gestational diabetes mellitus (GDM) and perinatal outcomes. Methods A prospective cohort study was conducted with 150 pregnant women with a singleton pregnancy. The study included pregnant women between 30 and 41 weeks with or without GDM. Fetal pancreatic circumference was measured using the free-hand tracking function. The echogenicity of the fetal pancreas was compared with the echogenicity of the liver and bone (ribs, spine) and classified as Grades 1, 2 and 3. The relationship between maternal characteristics and perinatal outcomes with fetal pancreas measurements and echogenicity was evaluated. Results Pregnant women with 75 GDM and 75 without GDM were included in the study. Mean fetal pancreas circumference measurements were significantly higher in pregnant women with GDM than in those without GDM (p=0.001). Hyperechogenic (Grade 3) fetal pancreas was significantly higher in pregnant women with GDM than in pregnant women without GDM, and there was a positive correlation between pancreatic echogenicity and HbA1c levels in pregnant women with GDM (r=0.631, p<0.01). There was a significant relationship between pancreatic echogenicity, measurements and adverse neonatal outcomes in pregnant women with GDM, and pancreas measurements were significantly higher in pregnant women with cesarean delivery. Conclusions Fetal pancreatic echogenicity and measurements in pregnant women with GDM can give an idea about glucose regulation and adverse perinatal outcomes.

Third‐trimester fetal pancreas imaging in uncomplicated pregnancies and association with pregnancy outcomes

“…Pancreatic circumference was measured using the free hand tracking function by freezing the image, and the average of two measurements was included in the analysis. The definition of echogenicity of the fetal pancreas was determined as grade 1, 2, and 3, similar to previous studies 10,11 . The same echogenicity as the fetal liver was defined as grade 1 (isoechoic), the echogenic appearance as much as the ribs was defined as grade 3 (echogenic), and the minimal echogenic appearance was defined as grade 2.…”

“…The definition of echogenicity of the fetal pancreas was determined as grade 1, 2, and 3, similar to previous studies. 10,11 The same echogenicity as the fetal liver was defined as grade 1 (isoechoic), the echogenic appearance as much as the ribs was defined as grade 3 (echogenic), and the minimal echogenic appearance was defined as grade 2.…”

“…We also found that increases in pancreatic size and echogenicity may also be predictive of adverse pregnancy outcomes. 11 In this study, we evaluated the relationship between fetal pancreas and pregnancy outcomes in pregnancies uncomplicated by diabetes. Our findings showed no relationship between PTB, LBW, mode of delivery, and fetal pancreas size.…”

“…Therefore, recent prenatal studies have focused on fetal pancreas development and imaging in diabetic pregnancies. The results of these studies showed increased echogenicity and size in sonographic imaging of the pancreas of fetuses exposed to a diabetic environment 10–13 …”

“…The results of these studies showed increased echogenicity and size in sonographic imaging of the pancreas of fetuses exposed to a diabetic environment. [10][11][12][13] Since there are a limited number of studies investigating the intrauterine imaging and function of the fetal pancreas, we aimed to examine the sonographic evaluation of the third trimester fetal pancreas in uncomplicated pregnancies and its association with pregnancy outcomes.…”