The relation between interventricular septum thickness and fetal macrosomia in patients with gestational diabetes mellitus

Document Type : Original Article

Authors

1 Obstetrics and Gynecology Department, Faculty of Medicine , Beni-Suef University, Egypt

2 Obstetrics and Gynecology Department, Faculty of Medicine , 6 October University, Egypt

Abstract

In this study we concluded that usefulness of sonographic umbilical cord thickness, interventricular septum thickness and HbA1c in prediction of fetal macrosomia in Patients with gestational diabetes mellitus. Umbilical cord area measurement may be combined with the standard fetal biometric parameters to improve the accuracy of identification of fetal macrosomia, allowing it to be better managed without unnecessary intervention, while possibly avoiding permanent injury. Fetal hyperinsulinism in combination with the normally increased expression and affinity of fetal insulin receptors can lead to proliferation and hypertrophy of cardiac myocytes. Hypertrophic cardiomyopathy is characterized by thickening of the interventricular septum, and to a lesser degree, the ventricular free walls. It is usually asymptomatic and resolves within the first year of life,. The rate of meconium aspiration and the need for mechanical ventilatory support are increased in this group of neonates. Maternal complications such as postpartum hemorrhage, infections, aswell as third- or fourth-degree vaginal lacerations may occur as a result of operative delivery

Keywords

Main Subjects


  1. Abdelrahman, R. M., & Salama, M. M. (2018). The role of Umbilical Cord thickness, Interventricular Septum thickness and HbA1c levels in the prediction of Fetal Macrosomia in patients with Gestational Diabetes Mellitus. J Gynecol Res Obstet, 4(3), 039-043.
  2. Billionnet, C., Mitanchez, D., Weill, A., Nizard, J., Alla, F., Hartemann, A., & Jacqueminet, S. (2017). Gestational diabetes and adverse perinatal outcomes from 716,152 births in France in 2012. Diabetologia, 60(4), 636-644.
  3. Binbir, B., Yeniel, A. O., Ergenoglu, A. M., Kazandi, M., Akercan, F., & Sagol, S. (2011). The role of umbilical cord thickness and HbA1c levels for the prediction of fetal macrosomia in patients with gestational diabetes mellitus. Archives of Gynecology and Obstetrics, 285(3), 635–639.
  4. Fayez Mohamed Fathi, M., Mohammed Moustafa, T., & Ramadan Alsawy Rady, I. (2020). The role of umbilical cord thickness and glycated hemoglobin (hba1c) levels for prediction of fetal macrosomia in patients with gestational diabetes mellitus. Al-Azhar Medical Journal, 49(4), 1741-1752.
  5. Gandhi, J. A., Zhang, X. Y., & Maidman, J. E. (1995). Fetal cardiac hypertrophy and cardiac function in diabetic pregnancies. American journal of obstetrics and gynecology173(4), 1132-1136.‏
  6. Helm, B. M., & Freeze, S. L. (2016). Genetic evaluation and use of chromosome microarray in patients with isolated heart defects: benefits and challenges of a new model in cardiovascular care. Frontiers in cardiovascular medicine3, 19.‏
  7. He, X. J., Qin, F. Y., Hu, C. L., Zhu, M., Tian, C. Q., & Li, L. (2015). Is gestational diabetes mellitus an independent risk factor for macrosomia: a meta-analysis?. Archives of gynecology and obstetrics291(4), 729-735.‏
  8. Inegbenebor, U., & Okosun, J. (2019) Identifying maternal nutritional risk factors associated with fetal macrosomia in Nigeria. Obstet Gynecol Int J, 10(3), 185-190.
  9. Liabsuetrakul, T., Choobun, T., Peeyananjarassri, K., & Islam, Q. M. (2017). Antibiotic prophylaxis for operative vaginal delivery. Cochrane Database of Systematic Reviews, (8).‏
  10. Said, A. S., & Manji, K. P. (2016). Risk factors and outcomes of fetal macrosomia in a tertiary centre in Tanzania: a case-control study. BMC pregnancy and childbirth16(1), 243.‏
  11. Lipshultz, S. E., Law, Y. M., Asante-Korang, A., Austin, E. D., Dipchand, A. I., Everitt, M. D., ... & Colan, S. D. (2019). Cardiomyopathy in children: Classification and diagnosis: A scientific statement from the American Heart Association. Circulation, CIR-0000000000000682.
  12. Júnior, E. A., Peixoto, A. B., Zamarian, A. C. P., Júnior, J. E., & Tonni, G. (2017). Macrosomia. Best Practice & Research Clinical Obstetrics & Gynaecology, 38, 83-96.
  13. Naylor, C. D., Sermer, M., Chen, E., & Sykora, K. (1996). Cesarean delivery in relation to birth weight and gestational glucose tolerance: pathophysiology or practice style?. Jama, 275(15), 1165-1170.
  14. Ogonowski, J., & Miazgowski, T. (2015). Intergenerational transmission of macrosomia in women with gestational diabetes and normal glucose tolerance. European Journal of Obstetrics & Gynecology and Reproductive Biology, 195, 113–116. doi:10.1016/j.ejogrb.2015.10.002