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Qureshey EJ, Bicocca MJ, Chauhan SP, Nowlen C, Soto EE, Sibai BM, Stafford I. Moderate-to-Severe Polyhydramnios: Cutoffs for Deepest Vertical Pocket Corresponding to Amniotic Fluid Index. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:2827-2834. [PMID: 35225371 DOI: 10.1002/jum.15970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/23/2022] [Accepted: 02/03/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Society for Maternal-fetal medicine Consult Series (#46) states "antenatal fetal surveillance is not required for mild idiopathic" polyhydramnios defined as amniotic fluid index (AFI) of 24 cm or a deepest vertical pocket (DVP) between 8 and 11 cm. The objective of this study was to determine the cutoff for DVP which correlates with AFI ≥ 30 cm. METHODS This retrospective study of singleton third trimester ultrasounds included a study group randomly divided into test and validation. In the test group, DVP cutoffs correlating with AFI ≥ 30 cm which was used to define moderate-severe polyhydramnios were calculated in two ways, rounded to the nearest whole number: 1) a receiver operating curve and Youden's J statistic (DVP-Youden) and 2) calculation of the DVP percentile that corresponded with AFI of 30 cm (DVP-Percentile). Using the validation group, diagnostic characteristics were DVP-Youden and DVP-Percentile for diagnosis of AFI ≥ 30 cm and were compared against SMFM cutoffs (DVP-SMFM). RESULTS Seventy one thousand eight hundred and ninety three ultrasound exams in the 3rd trimester had assessment of AFI and DVP. Moderate-severe polyhydramnios occurred in 286 (1.2%) in test group and 571 (1.2%) in validation group. AFI of 30 cm corresponded to the 98.9th percentile, which in turn correlated to a DVP of 10 cm (DVP-Percentile). The calculated cutoff for moderate-severe polyhydramnios was 8 cm for DVP-Youden. CONCLUSION Using 8.0 cm rather than 12.0 cm increased the detection of moderate-severe polyhydramnios to 100% with a false positive rate under 5%. For those utilizing DVP for amniotic fluid evaluation, identification of a DVP ≥ 8.0 cm should prompt further evaluation with complete AFI.
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Affiliation(s)
- Emma J Qureshey
- Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Matthew J Bicocca
- Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Suneet P Chauhan
- Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Carol Nowlen
- Department of Medical Genomics, Christiana Care, Newark, DE, USA
| | - Eleazar E Soto
- Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Baha M Sibai
- Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Irene Stafford
- Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
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Bicocca MJ, Qureshey EJ, Chauhan SP, Hernandez-Andrade E, Sibai BM, Nowlen C, Stafford I. Semiquantitative Assessment of Amniotic Fluid Among Individuals With and Without Diabetes Mellitus. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:447-455. [PMID: 33885190 DOI: 10.1002/jum.15725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To compare the rate and severity of abnormal amniotic fluid volumes (oligohydramnios or polyhydramnios), as well as the distribution of amniotic fluid levels, in pregnancies with and without diabetes. METHODS We performed a retrospective cohort study of singleton nonanomalous pregnancies receiving an ultrasound examination (USE) in the third trimester. Pregnancies were categorized into those with and without diabetes and subcategorized by diabetes type. The primary outcomes were oligohydramnios or polyhydramnios. Polyhydramnios was also examined by severity. The association between maternal diabetes status and oligohydramnios or polyhydramnios was assessed using logistic regression. In addition, we computed gestational age-specific amniotic fluid index (AFI) and deepest vertical pocket (DVP) centiles for pregnancies with and without diabetes. RESULTS There were 60,226 USEs from 26,651 pregnancies that met inclusion criteria. There were 3992 (15.0%) pregnancies with diabetes and 22,659 (85.0%) without diabetes. Using AFI, the rate of polyhydramnios was 10.5 versus 3.8% (odds ratio [OR] 2.95; 95% confidence interval [CI] 2.62-3.32) for pregnancies with versus without diabetes, respectively; using DVP, the rate of polyhydramnios was 13.9 versus 5.4% (OR 2.84; 95% CI 2.56-3.15). Rates of oligohydramnios were also increased in pregnancies with diabetes (3.3 versus 2.6%; OR 1.26; 95% CI 1.04-1.52). The AFI and DVP were significantly higher in the cohort with diabetes between 28 and 36 weeks. CONCLUSION Within our study population, pregnancies with diabetes had increased rates of oligohydramnios and polyhydramnios as well as increased gestational age-specific amniotic fluid volumes between 28 and 36 weeks. A higher prevalence of polyhydramnios was observed using DVP as compared to AFI; nevertheless, associations were similar using either method.
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Affiliation(s)
- Matthew J Bicocca
- Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Emma J Qureshey
- Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Suneet P Chauhan
- Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Edgar Hernandez-Andrade
- Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Baha M Sibai
- Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Carol Nowlen
- Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Irene Stafford
- Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
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Shub A, Lappas M. Pregestational diabetes in pregnancy: Complications, management, surveillance, and mechanisms of disease-A review. Prenat Diagn 2020; 40:1092-1098. [PMID: 32333803 DOI: 10.1002/pd.5718] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 03/12/2020] [Accepted: 04/20/2020] [Indexed: 12/16/2022]
Abstract
Diabetes is an increasingly common diagnosis among pregnant women. Pregestational diabetes is associated with an increase in many adverse pregnancy outcomes, which impact both on the woman and her fetus. The models of pregnancy care for women with diabetes are based largely on observational data or consensus opinion. Strategies for aneuploidy screening and monitoring for fetal well-being should be modified in women with diabetes. There is an increasing understanding of the mechanisms by which congenital anomalies and disorders of fetal growth occur, involving epigenetic modifications, changes in gene expression in critical developmental pathways, and oxidative stress. This knowledge may lead to pathways for improved care for these high-risk pregnancies.
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Affiliation(s)
- Alexis Shub
- Department of Obstetrics and Gynecology, University of Melbourne, Parkville, Australia.,Perinatal Department, Mercy Hospital for Women, Heidelberg, Australia
| | - Martha Lappas
- Department of Obstetrics and Gynecology, University of Melbourne, Parkville, Australia
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Fuchs F, Aouinti S, Souaied M, Keller V, Picot MC, Fries N, Ayoubi JM, Picone O. Association between amniotic fluid evaluation and fetal biometry: a prospective French "Flash" study. Sci Rep 2018; 8:7093. [PMID: 29728591 PMCID: PMC5935749 DOI: 10.1038/s41598-018-25497-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 04/20/2018] [Indexed: 12/16/2022] Open
Abstract
We aimed to study the association between three different methods of assessing the amount of amniotic fluid (subjective method (SM), deepest vertical pocket (DVP) and amniotic fluid index (AFI)) and estimated fetal weight (EFW) (in percentile or Z-score) after adjustment on maternal-fetal parameters. We performed a nationwide cross-sectional study through the French network of obstetric sonographers using the "flash" study method and including low-risk singleton pregnancies from 18-40 weeks. Crude and adjusted odds ratio were computed after stratification upon 2nd and 3rd trimester of pregnancy. 1667 ultrasound scans performed by 65 operators were included. Only Z-score of EFW was significantly associated with SM in both trimesters. For DVP and AFI, Z-score of EFW and male fetal gender was significantly associated with them in 2nd trimester. In the 3rd trimester, both Z-score of EFW and large (LGA) or small for gestational age (SGA) fetus were significantly associated with AFI. and DVP. Overweight woman and class I obesity women were also significantly associated with DVP modification. In conclusion, all three methods of amniotic fluid evaluation are significantly associated to estimated fetal weight. DVP and AFI appeared equivalent except that maternal-fetal factors seemed to have a higher impact in DVP than AFI.
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Affiliation(s)
- Florent Fuchs
- Department of Obstetrics and Gynecology, Montpellier University Hospital Center, 371 Avenue du Doyen Gaston Giraud, Montpellier, France.
- Inserm, CESP Centre for research in Epidemiology and Population Health, U1018, Reproduction and child development, Villejuif, France.
| | - Safa Aouinti
- Clinical Research and Epidemiology Unit (URCE), CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Manel Souaied
- Department of Obstetrics and Gynecology, Hopital Foch, 40 rue Worth, Suresnes, France
| | - Valentin Keller
- Department of Obstetrics and Gynecology, Hopital Foch, 40 rue Worth, Suresnes, France
| | - Marie-Christine Picot
- Clinical Research and Epidemiology Unit (URCE), CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Nicolas Fries
- Department of Obstetrics and Gynecology, Montpellier University Hospital Center, 371 Avenue du Doyen Gaston Giraud, Montpellier, France
- Collège Français d'Echographie Foetale, CFEF, France
| | - Jean-Marc Ayoubi
- Department of Obstetrics and Gynecology, Hopital Foch, 40 rue Worth, Suresnes, France
| | - Olivier Picone
- Department of Obstetrics and Gynecology, Hopital Foch, 40 rue Worth, Suresnes, France
- Collège Français d'Echographie Foetale, CFEF, France
- EA2493, UFR des sciences de la santé Simone Veil, Université Versailles Saint Quentin en Yvelines, Versailles, France
- Department of Obstetrics and Gynecology. Louis Mourier Hospital, Paris Nord Val de seine University Hospitals, APHP, Paris-Diderot University, 178 rue des Renouillers Colombes, Paris, France
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Agwu EJ, Ugwu AC, Shem SL, Abba M. Relationship of amniotic fluid index (AFI) in third trimester with fetal weight and gender in a southeast Nigerian population. Acta Radiol Open 2016; 5:2058460116652651. [PMID: 27570636 PMCID: PMC4984320 DOI: 10.1177/2058460116652651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 05/10/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Amniotic fluid (AF) is one of the major determinants of fetal biophysical profile and can predict pregnancy outcome. Abnormal value of amniotic fluid index (AFI) may indicate fetal and maternal disorders. PURPOSE To establish reference standards for AFI for this population after 28 weeks of pregnancy and evaluate the relationship between AFI, the estimated fetal weight (EFWT), and fetal gender. MATERIAL AND METHODS A prospective cross-sectional estimation of AFI and FWT was done in 385 apparently healthy pregnant women in the gestational age range of 28-42 weeks. General scanning in longitudinal, transverse, and oblique directions of the abdomen was done to assess the fetal wellbeing and determine the fetal gender for each participant. AF was measured in each of the quadrants of the abdomen. The four values of the AF were summed to get the AFI. Measurement of the head circumference, biparietal diameter, abdominal circumference, and femoral length of the fetus were obtained. The EFWT was calculated using Hadlock's formula. The data were divided into five groups: 28-30 weeks 6 days; 31-33 weeks 6 days; 34-36 weeks 6 days; 37-39 weeks 6 days; and 40-42 weeks. AFI for the different gestational age group studied and their percentiles were obtained. RESULTS AFI normogram for the local population was established. Positive and significant correlations of AF and EFWT were seen in all the gestational age groups of the women. No significant correlations between AF and EFWT was seen in male fetuses. Regression equations of EFWT and AFI were obtained for female fetuses. CONCLUSION The normal range for AFI values for the third trimester was established and could be used to evaluate AFI in the studied population. Established fetal weight should be taken into account when interpreting AFI for female fetuses but this need not be applied for male fetuses.
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Affiliation(s)
- Emeka John Agwu
- Radiology Unit, New Hope Hospital, Onitsha Anambra State, Nigeria
| | - Anthony C Ugwu
- Department of Radiography and Radiological Sciences, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University Nnewi Campus, Nigeria
| | - Samuel L Shem
- Radiology Department, State Hospital, Gombe, Nigeria
| | - Muhammed Abba
- Department of Radiography and Radiological Sciences, College of Health Sciences, Bayero University, Kano, Nigeria
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Onwuzu S, Eze C, Ugwu L, Abonyi O, Adejoh T. Ultrasound biometry of normal human amniotic fluid index in a Nigerian population. Radiography (Lond) 2016. [DOI: 10.1016/j.radi.2015.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ipek A, Idilman IS, Kurt A, Cay N, Unal O, Erdogan BD, Keskin HL, Arslan H. Foetal biometry in polyhydramnios: Does femur length fall behind? J OBSTET GYNAECOL 2015; 36:312-7. [DOI: 10.3109/01443615.2015.1049992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Aminotic Fluid Index and its Correlation with Fetal Growth and Perinatal Outcome. JOURNAL OF FETAL MEDICINE 2015. [DOI: 10.1007/s40556-015-0049-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wadnere N, Kosta S, Kumar R. Association between fetal weight and amniotic fluid index in women of Central India. Adv Biomed Res 2014; 3:243. [PMID: 25538929 PMCID: PMC4260291 DOI: 10.4103/2277-9175.145751] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Accepted: 02/06/2014] [Indexed: 12/01/2022] Open
Abstract
Background: The placenta is important for fetal growth and well-being. Defective placentation and impaired placental circulation may result in anomalies in fetal growth. Placental volume in the second trimester appears to be closely related to the neonatal weight. The association of body weight with urine output has been observed in human neonates. Our goal is to assess the association of the amniotic fluid index (AFI) with the estimated fetal weight (EFW). Materials and Methods: Thirteen hundred and ninety-three pregnant women were prospectively studied by means of an ultrasound over a 12–month period. The fetal weight (FW) was estimated using a combination of fetal parameters – bi-parietal diameter, fetal trunk cross-sectional area, and femur length. AFI was assessed using the four quadrant method. The level of statistical significance was set at P ≤ 0.05. Results: There was no statistically significant association between AFI and EFW (P > 0.05; r = 0.413). We also did not find a significant association between AFI and EFW for all subdivisions of gestation age, except in the 24 – 28 weeks and 29 – 32 weeks’ groups. Conclusion: The FW calculations and amniotic index show a variation in values in late pregnancy. There does not appear to be a linear association between the ultrasound estimate of FW and the amniotic index. The implication of this is that the fetal size need not be taken into cognizance when alterations in amniotic fluid values are noted.
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Affiliation(s)
- Nitin Wadnere
- Department of Radiodiagnosis, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India
| | - Susmit Kosta
- Central Research Laboratory, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India
| | - Ravindra Kumar
- Central Research Laboratory, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India
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Bhagat M, Chawla I. Correlation of amniotic fluid index with perinatal outcome. J Obstet Gynaecol India 2013; 64:32-5. [PMID: 24587604 DOI: 10.1007/s13224-013-0467-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2013] [Accepted: 09/02/2013] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES We aimed to evaluate the predictive value of amniotic fluid index (AFI) (<5) for adverse perinatal outcome in terms of cesarean section for fetal distress, birth weight, meconium staining, Apgar scores, and cord pH at birth. METHODS This was a prospective study of 200 antenatal women booked at Ram Manohar Lohia (RML) Hospital during the years 2009-2011 with gestational age between 34 and 41 weeks. The women's history, clinical examination recorded, and AFI were measured and the perinatal outcome was compared between two groups, i.e., AFI < 5 and >5. RESULTS The cesarean section rate for fetal distress and low birth weight babies, <2.5 kg, was higher in patients with oligohydramnios (p = 0.048, 0.001, respectively). There was no significant difference in meconium staining, Apgar score at 5 min <7, and cord pH at birth between the two groups (p = 0.881, 0.884, 0.764, respectively). CONCLUSIONS Oligohydramnios has a significant correlation with cesarean section for fetal distress and low birth weight babies.
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Affiliation(s)
- Megha Bhagat
- Department of Obstetrics and Gynecology, Dr. Ram Manohar Lohia Hospital, New Delhi, India ; H. NO.-209, Pragati Apartment, Paschim Vihar, New Delhi, 110063 India
| | - Indu Chawla
- Department of Obstetrics and Gynecology, Dr. Ram Manohar Lohia Hospital, New Delhi, India
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Adeyekun AA, Awosanya GG. Relationship between amniotic fluid index and ultrasound estimated fetal weight in healthy pregnant african women. J Clin Imaging Sci 2013; 3:2. [PMID: 23607072 PMCID: PMC3625886 DOI: 10.4103/2156-7514.106614] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 12/15/2012] [Indexed: 11/11/2022] Open
Abstract
Introduction: Fetal weight (FW) estimation in late pregnancy is an important guide in obstetric care. Amniotic fluid protects the fetus against traumatic and infective insults. There possibly exists a relationship between FW and amniotic fluid index (AFI) that can be estimated by ultrasonography. Materials and Methods: Two hundred and fifty-eight low-risk pregnancies were prospectively studied by means of ultrasound over a 12-month period. FW was estimated using a combination of fetal parameters; bi-parietal diameter, fetal trunk cross sectional area, and femur length. AFI was assessed using the 4-quadrant method. Spearman's correlation was used to test possible relationship between amniotic fluid indices and estimated FW pairs. The level of statistical significance was set at P ≤ 0.05. Results: The mean AF1 and estimated fetal weight (EFW) pairs were as follows: at 27-29 weeks the values were 172.1 mm and 1,250.2 g; at 30-32 weeks AF1 and EFW values were 170.3 mm and 1,648.0 g; at 33-35 weeks values were 162.3 mm and 2,273.5 g; at 36-38 weeks values were 144.09 mm and 2,906.1 g; at 39-40 weeks AF1 and EFW values were 125.0 mm and 3,222.6 g. Overall, there was no statistically significant relationship between AFI and EFW (P > 0.05; r = 0.241). Conclusion: While FW calculations and amniotic index showed variations in value in late pregnancy, there does not appear to be a linear relationship between ultrasound estimate of FW and amniotic index. The implication of this is that fetal size need not be taken into cognizance when alterations in amniotic fluid values are noted.
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Affiliation(s)
- Ademola A Adeyekun
- Department of Radiology, University of Benin Teaching Hospital, Benin City, Nigeria
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Gojnic M, Perovic M, Pervulov M, Ljubic A. The effects of adjuvant insulin therapy among pregnant women with IGT who failed to achieve the desired glycemia levels by diet and moderate physical activity. J Matern Fetal Neonatal Med 2012; 25:2028-34. [PMID: 22480146 DOI: 10.3109/14767058.2012.672598] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Evaluation of adjuvant insulin therapy effects on glycemic control, perinatal outcome and postpuerperal glucose tolerance in impaired glucose tolerance (IGT) pregnant women who failed to achieve desired glycemic control by dietary regime. METHODS A total of 280 participants were classified in two groups: Group A patients continued with dietary regime and Group B patients were treated with adjuvant insulin therapy. Glycemic control was assessed by laboratory and ultrasonograph means. Pregnancy outcomes were evaluated by prevalence of pregnancy induced hypertension (PIH), high birth weight, neonatal hypoglycemia and caesarean section rates. Postpuerperal glucose tolerance was assessed by oral glucose tolerance test (oGTT). RESULTS All laboratory and ultrasound indicators of glycemic control had significantly lower values in Group B. Group A women were more likely to develop the EPH (Edema, Proteinuria, Hypertension) syndrome, 20% versus 7.86% (p = 0.003). High birth weight occurred more frequently in Group A, but the difference was not significant (p = 0.197). Higher rate of caesarean delivery was in Group A than in Group B, 16.43% versus 26.43% (p = 0.041). The difference in neonatal hypoglycemia was not significant (p = 0.478). Pathological oGTT results were observed in 73 Group A patients and in 15 Group B patients. CONCLUSION Lower caesarean section rates and the EPH syndrome incidence are the benefits of adjuvant insulin therapy in IGT patients.
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Affiliation(s)
- Miroslava Gojnic
- Institute of Gynecology and Obstetrics, Clinical Centre of Serbia, Clinical Hospital Centre, Zemun, Belgrade, Serbia
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Abstract
Maternal hyperglycemia is responsible for many fetal adverse outcomes. Ultrasound examination of these pregnancies aims at an early detection of congenital malformations, assessment of fetal well-being, and fetal growth. This evaluation will influence clinical decision in determining the best time and mode of delivery. We reviewed data from the literature on accuracy, usefulness, and indications of ultrasound examinations in pregnancies complicated with diabetes mellitus, whether pregestational or gestational.
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Affiliation(s)
- Jacky Nizard
- CHI Poissy-Saint-Germain en Laye, Poissy, France
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