scholarly journals Prospective study on sonographic measurement of umbilical cord thickness, foetal fat layer, interventricular septal thickness as predictors of macrosomia in fetus of women with gestational diabetes mellitus

Author(s):  
Janani N. ◽  
Vimala D. ◽  
Gayathri N.

Background: The objectives of the study were to evaluate the Prediction of foetal macrosomia based on sonographic measurements of foetal fat layer, Interventricular septal thickness and umbilical cord thickness in Gestational Diabetes Mellitus at term.Methods: After assessment of inclusion and exclusion criteria 100 antenatal women of gestational age more than 37 weeks selected for study in the Department of Obstetrics and Gynaecology of Vinayaka Mission’s Kirupananda variyar medical college and hospital, Salem. Participants underwent a third trimester scan and three extra measurements i.e. Umbilical cord thickness, Interventricular septal thickness and foetal fat layer are measured in addition to the normal examination.Results: In present study umbilical cord thickness had good sensitivity and negative predictive value. Hence, if umbilical cord thickness is less than 90th centile the chance of macrosomia is less, the cut off of foetal fat layer ≥5 mm as predictor of macrosomia had sensitivity of 84.2% and specificity of 86.4% and cut off of Interventricular septal thickness ≥3.9mm as a predictor of macrosomia had sensitivity of 84.2%, specificity of 64.2%, negative predictive value of 95.9%. Thus, interventricular septal thickness and foetal fat layer is a reliable predictor of macrosomia.Conclusions: From this study authors concluded that Umbilical cord thickness, foetal fat layer and Interventricular septal thickness are good predictors of foetal macrosomia. In the assessment of risk of macrosomia in addition to the ultrasonographic measurements the clinical risk factors must be considered.

1970 ◽  
Vol 9 (1) ◽  
pp. 21-25 ◽  
Author(s):  
Sanjoy Kumar Chakraborty ◽  
BM Ali Yousuf ◽  
Laila Anjuman Banu ◽  
Khondker Manzare Shamim

Objective: Clinically the adverse effects of the diabetes on the out come of pregnancy are well established. The present study was designed to look for the impacts of gestational diabetes on the gross and histomorphological features of the umbilical cord. Type of study: A descriptive study having analytical components. Place and period of study: Department of Anatomy, Chittagong Medical College, Chittagong, from May 2006 to April 2007. Materials: Total fifty (50) umbilical cords with the placenta were collected within 36th to 40th weeks of gestation from Chittagong Medical College hospital and Memon maternity hospital of Chittagong City Corporation. Out of them 25 cords were from non diabetic pregnant mother (Control group) and 25 cords from mothers with gestational diabetes mellitus (GDM group). Method: After proper fixation with 10% formalin the diameter of the umbilical cord were measured with a vernier calipers in millimeters. Circumference, Cross-Sectional Area (CSA) of the umbilical cord and CSA of the Wharton’s jelly were measured by computerized micrometric method in millimeters and sq. millimeters respectively. Number of the umbilical vessels were examined and counted on the cut surface of the umbilical cord, later confirmed by histological examination. Presence or absence of the true knots were noted. Result: Among the gross morphological variables of the umbilical cord, the mean diameter was significantly larger in the GDM group than in the Control group (P< 0.05). Though the mean circumference, mean CSA of the umbilical cord and mean CSA of the Wharton's jelly were found to be higher in the GDM group than in the Control group, but the difference did not reach to the significant level. All the cords of the GDM group, the umbilical cord contained two arteries and one vein, whereas, two cords of the Control group, the umbilical cord had three arteries and one vein and one cord contain four arteries and one vein. No true knots were found in any groups. Pearson’s correlation test revealed significant positive correlation in both GDM and Control groups between mean diameter and circumference of the umbilical cord (r = 0.881, P = 0.000 & r = 0.689, P = 0.000) and between CSA of the umbilical cord and Wharton's jelly (r = 0.988, P = 0.000 & r = 0.990, P = 0.000). Key words: Umbilical cord; Gross and Histomorphology; GDM. DOI: http://dx.doi.org/ 10.3329/bja.v9i1.8143 Bangladesh Journal of Anatomy January 2011, Vol. 9 No. 1 pp 21-25


2017 ◽  
Vol 11 (1) ◽  
pp. 25-28
Author(s):  
Farzana Akonjee Mishu ◽  
MA Muttalib

Background and objectives: Alteration of magnesium (Mg) and copper (Cu) concentrations in blood has been observed in normal pregnancy as well as in gestational diabetes mellitus (GDM). The present study was aimed to evaluate the serum Mg and Cu levels in Bangladeshi women with GDM in their second and third trimester of pregnancy.Methods: The study was conducted at Mymensingh Medical College Hospital from July 2013 to June 2014. Pregnant women, in their second and third trimester, attending the outpatient department of Obstetrics and Gynecology and the Department of Endocrinology of Mymensingh Medical College Hospital were enrolled by purposive sampling technique. GDM was diagnosed on the basis of oral glucose tolerance test (OGTT) as defined in WHO criteria 2013. Blood glucose was estimated by enzymatic GOD-PAP colorimetric method. The cut off value for fasting plasma glucose level was ?6.1 mmol/L or ?7.8 mmol/L 2 hours after glucose load. Serum Cu was estimated by 3, 5-DiBr-PAESA method and Mg by Xylidyl Blue-I Method as per manufacturer’s instruction.Results: A total of 172 pregnant women in their second and third trimester were enrolled. Out of 172 participants, 86 had GDM and 86 were normoglycemic (control). The mean age of GDM and control groups was 28.6±3.2 years and 27.3±3.1 years respectively. The BMI was 26.4±1.5 m/kg2 and 26.3±1.3 m/kg2. Serum Mg level was significantly low (p< 0.001) in 2nd and 3rd trimesters in GDM cases (1.39±0.26 mg/dl and 0.93±0.15 mg/dl) compared to control group (1.67±0.3 mg/dl and 1.67±0.31mg/dl). On the contrary, serum Cu levels in GDM cases were significantly (p<0.002) higher in both trimesters (224±333.8 ?g/dl and 243.91±6.89 ?g/dl) compared to those without GDM (220.1±7.6 ?g/dl and 234.9±4.6 ?g/dl). There was significant (p<0.001) increase of serum Cu levels in 3rd trimester compared to 2nd trimester in both GDM and non GDM cases.Conclusion: There was distinct alteration of serum Mg and Cu levels in GDM compared to normal pregnancy.IMC J Med Sci 2017; 11(1): 25-28


2021 ◽  
Vol 73 (5) ◽  
Author(s):  
Pornpimol Ruangvutilert ◽  
Thanapa Rekhawasin ◽  
Chayawat Phatihattakorn ◽  
Dittakarn Boriboonhirunsarn

Objective: To determine the accuracy of ultrasonography for predicting a large-for-gestational-age (LGA) newborn in women with gestational diabetes mellitus (GDM).Materials and Methods: Singleton pregnancy, diagnosed with GDM were recruited. They underwent ultrasonography at 32-36 weeks’ gestation for fetal biometry. Biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL). Estimated fetal weight (EFW) was derived from these 4 parameters by Hadlock formula. Delivery of an LGA newborn in women with the ultrasound finding of LGA fetus was the primary outcome.Results: Of 345 studied women, 107 (31%) had an LGA newborn. EFW of ≥ 90 th percentile at third trimester ultrasonography was found in 13 women, all of whom had an LGA newborn. It had a positive predictive value (PPV), specificity, sensitivity and negative predictive value (NPV) of 100%, 100%, 12.1% and 71.7% respectively to predict LGA at birth. Considering each fetal parameter individually, AC > 90 th percentile and HC > 90 th percentile had odds ratios (OR) with 95% confidence intervals of the newborn being LGA of 6.5 (3.3-12.8) and 2.0 (1.0-4.0) respectively while EFW > 85 th percentile had the highest OR of 9.3 (1.1-77.9). Lowering cutoff values of EFW to 80 th and 70 th percentile increased the sensitivity and NPV for prediction of LGA at birth while reducing the PPV and specificity slightly.Conclusion: EFW derived from the third trimester ultrasonography in GDM had high PPV and specificity with low to moderate sensitivity and NPV to predict an LGA newborn in GDM.


Author(s):  
Elia Shazniza Shaaya ◽  
Siti Atiqah Abdul Halim ◽  
Ka Wen Leong ◽  
Kevin Boon Ping Ku ◽  
Pei Shan Lim ◽  
...  

Background:Candida chorioamnionitis is rarely encountered, even though vulvovaginal candidiasis incidence is about 15%. Interestingly, it has characteristic gross and histological findings on the umbilical cord that are not to be missed. Case Report: We report two cases of Candida chorioamnionitis with presence of multiple yellowish and red spots of the surface of the umbilical cord. Microscopically, these consist of microabscesses with evidence of fungal yeasts and pseudohyphae. The yeasts and pseudohyphae were highlighted by periodic acid– Schiff and Grocott methenamine silver histochemical stains. Both cases were associated with a history of gestational diabetes mellitus. Discussion: Peripheral funisitis is a characteristic feature of Candida chorioamnionitis. It is associated with high risk of adverse perinatal and neonatal outcomes, such as preterm delivery, stillbirth and neonatal death. We recommend careful examination of the umbilical cord of mothers with gestational diabetes mellitus.


2008 ◽  
Vol 31 (7) ◽  
pp. 610-613 ◽  
Author(s):  
M. Akturk ◽  
A. E. Altinova ◽  
I. Mert ◽  
U. Buyukkagnici ◽  
A. Sargin ◽  
...  

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1011
Author(s):  
Sofia Nevander ◽  
Eva Landberg ◽  
Marie Blomberg ◽  
Bertil Ekman ◽  
Caroline Lilliecreutz

Gestational diabetes mellitus (GDM) is a common complication with negative impacts on mother and child. The primary aim of this study was to examine whether plasma glucose cutoffs for GDM diagnosis based on venous sampling can be replaced by cutoffs based on capillary sampling. A prospective cross-sectional study was performed at an antenatal care clinic including 175 pregnant women undergoing an oral glucose tolerance test (OGTT). Duplicate samples were collected by capillary and venous puncture while fasting and 1 h and 2 h after an OGTT. Both samples were analyzed on Accu-Chek Inform II. The cutoffs for a GDM diagnosis using capillary samples were corrected from 5.1 to 5.3 mmol/L for the fasting sample, from 10.0 to 11.1 mmol/L for the 1 h sample, and from 8.5 to 9.4 mmol/L for the 2-h sample using half of the dataset. Applying these cutoffs to the remaining dataset resulted in a sensitivity, specificity, and accuracy of 85.0%, 95.0%, and 90.3%, respectively, with a positive predictive value (PPV) of 83%, an negative predictive value (NPV) of 96%, and a positive negative likelihood ratio (LHR) of 16.4 using capillary sampling for the GDM diagnosis at fasting and 2-h after. Corrected cutoffs and capillary samples can be used for the diagnosis of GDM with maintained diagnostic accuracy using Accu-Chek Inform II.


2018 ◽  
Vol 27 (1) ◽  
pp. 51-56
Author(s):  
Ferdousi Hossain Poly ◽  
Syeda Afroza ◽  
Hasanur Rahman ◽  
Md Imran Hassan

A congenital heart defect is a heart problem which is present at birth, caused by improper development of the heart during fetal development. In majority of cases there is no known reason for the heart to develop improperly. Some type of congenital heart defects are related to chromosomal abnormality(5-6%), some are to single gene defect(3-5%) or environmental factors(2%). In 85-90% of cases there is no identifiable cause and are generally considered to be caused by multifactorial inheritance. There are some maternal factors which have some role in cardiovascular malformations. These include high maternal age(above 30 years), maternal obesity, consanguinity among the parents, fever during pregnancy, gestational diabetes mellitus, smoking, alcohol consumption, ingestion of any teratogenic drug including homeopathy and herbal medicine. Objective of the study: To evaluate the risk factors associated with congenital heart disease. Methodology: A case control study was conducted at paediatric department of Sir Salimullah Medical College & Mitford Hospital following approval of the protocol from 1st January 2013 to 30th June 2014. Children fulfilling the inclusion criteria-(0-5 year old children of both sexes admitted in paediatric units of Mitford Hospital with any type of congenital heart disease confirmed by echocardiography) were considered as cases. A similar number of age and sex matched children admitted in Mitford Hospital without any cardiac defect were considered as controls. Data were collected by questionnaire. Results: The results show that majority of the cases are male. Maternal age (27.09 ± 4.63) and BMI (24.10 ± 2.28) both are significantly higher in cases than those of controls. Among the cases 31.8% mothers had consanguineous marriage (p=0.001) and 27.1% mothers had history of fever during pregnancy whereas it was present in 9.3% mothers of controls, the difference is significant statistically (p=0.001). Among the cases 34.6% mothers had history of gestational diabetes mellitus and only 18.9% controls had so and the difference is significant statistically (p=0.014). Conclusion: Relatively old age and more weight during pregnancy, consanguinity between parents, fever during pregnancy, history of gestational diabetes mellitus are the main risk factors of congenital heart defects in children J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 51-56


Author(s):  
Priyanka Inaniya ◽  
B S Meena ◽  
Mohan Lal Meena ◽  
Aparna Sharma ◽  
Shalini Rathore

Background: The present study aimed to study the demographic profile women with gestational diabetes mellitus Methods: This hospital based cross-sectional study Department of Obstetrics and Gynaecology, SMS Medical College, Jaipur. Results: Mean age of patients was 27.68 ± 4.4 Yrs. Most of the study subjects in GDM group (54.7%) were Hindu. Study subjects in GDM group were almost equally from rural (50.7%).Most of the study subjects in both GDM group (88%) were housewives. Habit of smoking was found in only 6.7% females in GDM group. Habit of alcohol was found in 4% females in GDM group. Family history of diabetes was seen more in females with GDM (17.3%). Conclusion: This study concluded that the socio demographic factors influence the occurrence of GDM. Keywords: GDM, Age, Gravida


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