Evaluation of Fetal Lung Maturity by Quantitative Analysis (quantusFLM) in Women with Gestational Diabetes Mellitus

Abstract

Objectives: The aim of the present study was to evaluate fetal lung maturity using the noninvasive method of quantitative ultrasound analysis of fetal lung texture (quantusFLM) in women with gestational diabetes mellitus (GDM). Methods: A total of 96 women at 36–38 weeks of gestation were enrolled. They were classified as follows: 33 GDM cases treated with diet, 30 GDM cases treated with diet plus insulin, and 33 normoglycemic women (control group). A quantitative analysis of lung texture was performed. Results: There were significant differences in the lung maturity results among groups (p = 0.004). These differences were established between the insulin-treated group of patients and both the control (p = 0.006) and diet-only (p = 0.003) groups. While none of the women in the control group or in the diet group had a high risk of immaturity, 16.7% of those treated with insulin (5/30) did (p = 0.003). There was no statistically significant correlation between HbA1c and the result of the test. Conclusions: Quantitative ultrasound study of fetal lung texture suggests that a significant percentage of pregnant women with GDM treated with insulin had fetal lung immaturity in the late preterm to early term.

The effect of gestational diabetes mellitus on fetal right heart growth in late‐term pregnancy: A prospective study

“…Particularly, we observed significant differences in right heart indicators, such as the RV, TAPSE, and s'. These results suggest that GDM may have a profound impact on the development of the fetal right heart during late‐term pregnancy, which is consistent with the findings of recent clinical studies 22,28 …”

“…The delay of lung maturity may explain this phenomenon. As the lung maturity of GDM fetus occurs later than the normal fetus on the 28–34 weeks, the fetal right ventricle working function may be influenced simultaneously 22,23 . This could lead to heart remodeling continuing into adulthood, and increased susceptibility to adult diseases 24 …”

“…As the lung maturity of GDM fetus occurs later than the normal fetus on the 28-34 weeks, the fetal right ventricle working function may be influenced simultaneously. 22,23 This could lead to heart remodeling continuing into adulthood, and increased susceptibility to adult diseases. 24 The tricuspid annular peak systolic velocity (s') is an indicator of systolic right ventricular function.…”

“…These results suggest that GDM may have a profound impact on the development of the fetal right heart during late-term pregnancy, which is consistent with the findings of recent clinical studies. 22,28…”

Fetal Lung Echo Texture in Pregnancies at Risk for Pulmonary Hypoplasia

“…Previous studies on the fetal lung echo texture have focused on prediction of respiratory morbidity in otherwise low‐ or moderate‐risk groups at a given gestational age 17,19,20,25 . Others have evaluated changes in the ultrasound appearance of lung tissue throughout gestation 26,27 .…”