The value of mid-trimester fetal liver length measurement in prediction of gestational diabetes in Iraqi women

Abstract

Background. Gestational diabetes (GD) is a hyperglycaemic state specific to pregnancy. A well-tolerated, quick and minimally-invasive method for the early detection of GD in pregnancy is lacking. Objective. To evaluate the correlation between the mid-trimester length of the fetal liver and GD. Methods. A prospective study was conducted at the

A Glimpse at the Size of the Fetal Liver—Is It Connected with the Evolution of Gestational Diabetes?

“…Early diagnosis and treatment are mandatory in GDM as there are a number of severe complications that can occur in both the fetus and the mother. These include preeclampsia, premature birth, polyhydramnios, macrosomia, postnatal hypoglycemia, and jaundice, neonatal respiratory distress syndrome, and an increased risk of developing birth defects, the latter occurring in up to 10% of diabetic pregnancies [4,5,68]. Pregnancies with GDM are shorter and the proportion of cesarean sections is much higher than in normal pregnancies.…”

“…Sci. 2021, 22, 7866 2 of 18 second or third trimester [1][2][3][4][5]. It was suggested to include in this definition the preexisting, nonidentified cases of type 2 diabetes mellitus ("overt diabetes") and type 1 diabetes mellitus, but these are detected very early after the onset of the pregnancy [6,7].…”

“…The use of several drugs, e.g., antidepressants, antipsychotics, beta-adrenergics, or corticosteroids, has been linked with an increased risk of GDM as well [34][35][36]. In addition, some other factors that can be incriminated in the development of GDM are macrosomia (exaggerated somatic development of the fetus) during the current pregnancy or 2 or more episodes of glycosuria during the second or third trimester of gestation [2,5].…”

“…Thus, all pregnant women should be subjected to this test at 24-28 weeks of gestation, although a recent study showed that GDM diagnosed at 24-28 weeks of gestation has already impacted the fetus but only in older and obese women, suggesting the necessity of screening before this period [8]. The cutoff values for the OGTT are blood glucose of 92, 180, and 153 mg/dL, before administration of 75 g of oral glucose and one and two hours after, respectively [2,4,5,37]. Although this method is superior to the measurement of fasting blood glucose or glycated hemoglobin (HbA1c), it also has some disadvantages, such as high cost and duration, low reproducibility, and discomfort caused to the patient by the high amount of carbohydrates that has to be ingested in a very short period of time [5,37].…”

“…The cutoff values for the OGTT are blood glucose of 92, 180, and 153 mg/dL, before administration of 75 g of oral glucose and one and two hours after, respectively [2,4,5,37]. Although this method is superior to the measurement of fasting blood glucose or glycated hemoglobin (HbA1c), it also has some disadvantages, such as high cost and duration, low reproducibility, and discomfort caused to the patient by the high amount of carbohydrates that has to be ingested in a very short period of time [5,37].…”