Anudeep Dirisala, Pati Shivanand, Sajjan Siddaroodha, Koppal Divyashree, Kolekar Pavan
Radiodiagnosis, Shri B. M. Patil Medical College, Hospital and Research Centre, Bijapur Liberal District Educational (BLDE) Association (Deemed to Be University), Vijayapura, IND.
Cureus. 2025 May 15;17(5):e84198. doi: 10.7759/cureus.84198. eCollection 2025 May.
Fetal macrosomia is a common and concerning complication of gestational diabetes mellitus (GDM), associated with increased risks for both maternal and neonatal morbidity. Traditional methods of predicting macrosomia often lack precision, particularly in diabetic pregnancies. This study aimed to evaluate the efficacy of three sonographic parameters, umbilical cord thickness (UCT), fetal fat layer (FFL), and interventricular septal thickness (IVS), as predictors of fetal macrosomia in women with GDM.
This prospective study included 123 pregnant women with GDM between 34 and 40 weeks of gestation. Comprehensive maternal data, including body mass index (BMI) and glycemic parameters (fasting blood sugar (FBS), postprandial blood sugar (PPBS), and glycated hemoglobin (HbA1c)), were recorded. Sonographic measurements of UCT, FFL, and IVS were performed and analyzed for their association with birth outcomes. Macrosomia was defined as a birth weight greater than 4000 g.
Macrosomia occurred in 62.6% of pregnancies, with strong associations with maternal BMI (p<0.001) and HbA1c levels (p<0.001). Sonographic parameters showed significant correlations with birth weight: UCT (r=0.792, p<0.001), FFL (r=0.34, p<0.001), and IVS (r=0.295, p=0.001). A UCT ≥25 mm demonstrated excellent sensitivity (93.3%) and specificity (85.4%) for predicting macrosomia. FFL ≥4.5 mm showed high specificity (93.3%) and positive predictive value (PPV) (97.3%), while IVS ≥3.9 mm exhibited good specificity (85%) but lower sensitivity (71.8%). Despite the high prevalence of macrosomia, 88.6% of deliveries were uncomplicated, though the cesarean section rate was high (64.2%).
Sonographic measurements of UCT, FFL, and IVS are valuable predictors of fetal macrosomia in GDM pregnancies. UCT, in particular, demonstrated the strongest correlation with birth weight and superior diagnostic accuracy. The integration of these sonographic parameters with maternal factors can enhance the accuracy of macrosomia prediction, potentially improving clinical decision-making and optimizing maternal and neonatal outcomes.
巨大胎儿是妊娠期糖尿病（GDM）常见且令人担忧的并发症，与孕产妇和新生儿发病风险增加相关。传统的巨大胎儿预测方法往往缺乏精准性，尤其是在糖尿病妊娠中。本研究旨在评估脐带厚度（UCT）、胎儿脂肪层（FFL）和室间隔厚度（IVS）这三个超声参数作为GDM孕妇巨大胎儿预测指标的有效性。
这项前瞻性研究纳入了123例妊娠34至40周的GDM孕妇。记录了包括体重指数（BMI）和血糖参数（空腹血糖（FBS）、餐后血糖（PPBS）和糖化血红蛋白（HbA1c））在内的全面孕产妇数据。对UCT、FFL和IVS进行超声测量，并分析它们与分娩结局的相关性。巨大胎儿定义为出生体重超过4000g。
62.6%的妊娠发生巨大胎儿，与孕产妇BMI（p<0.001）和HbA1c水平（p<0.001）密切相关。超声参数与出生体重显著相关：UCT（r = 0.792，p<0.001）、FFL（r = 0.34，p<0.001）和IVS（r = 0.295，p = 0.001）。UCT≥25mm对预测巨大胎儿具有出色的敏感性（93.3%）和特异性（85.4%）。FFL≥4.5mm显示出高特异性（93.3%）和阳性预测值（PPV）（97.3%），而IVS≥3.9mm表现出良好的特异性（85%）但敏感性较低（71.8%）。尽管巨大胎儿的发生率很高，但88.6%的分娩无并发症，不过剖宫产率较高（64.2%）。
UCT、FFL和IVS的超声测量是GDM妊娠中巨大胎儿的有价值预测指标。特别是UCT与出生体重的相关性最强，诊断准确性更高。将这些超声参数与孕产妇因素相结合可以提高巨大胎儿预测的准确性，有可能改善临床决策并优化孕产妇和新生儿结局。
