Sonographic Assessment of fetal subcutaneous Fat thickness as an indicator of gestational diabetes

Background: Gestational diabetes is the most common metabolic complication affecting women during pregnancy. It is a critical issue during pregnancy, due to possible maternal and fetal complications. The most common consequence to the fetus is macrosomia, which has an incidence rate of 26% among diabetic pregnancies. It is well known that adipose tissue thickness and skin fold thickness are greater in newborns of mothers with gestational diabetes than in the offspring of mothers with normal glucose metabolism Fetal adiposity is known to be a consequence of maternal diabetes. Recently, ultrasound had been used as a non invasive and well-tolerated method to compare the measurements of subcutaneous fetal fat tissue in pregnancies with normal and abnormal GTT as an additional tool in predicting gestational diabetes. Aim of the work: The present study was designed to investigate the use of ultrasound to compare the measurements of subcutaneous fetal fat in pregnancies with normal and abnormal GTT, as an additional tool in predicting gestational diabetes. Patients and methods: It was performed at Al-Azhar university hospital, New Damietta, Obstetrics and Gynecology Department. Fifty women with singleton pregnancies between 24 and 26 weeks’ gestation were participate in our study. We measured fetal subcutaneous fat tissue thickness and fetal weight in 25 women with abnormal GTT (Group A, study group) and 25 women with normal GTT (Group B, control group). Each patient was underwent two-dimensional (2D) ultrasound evaluation between 24, 26 weeks. At least two measurements were taken for each parameter. Results of the present study revealed that: There was statistically non-significant difference between the study and the control group as regard BMI; Fetuses of mothers in the study group showed statistically significant increase of fetal tissue thickness in all measures areas in comparison to the control group; The study group showed statistically significant increase of cesarean delivery in comparison to the control group; Fetuses of mothers in the study group showed statistically significant increase of fetal birth weight in comparison to control group. Conclusion: The results of the present study suggest the possibility of using sonographically determined fetal subcutaneous fat measurements as a criterion to distinguish women at high risk for gestational diabetes. Assessing these parameters is easily reproducible, noninvasive and could enable real-time detection of fetal overgrowth and disproportion, potentially resulting in early detection and reducing fetal morbidity. In addition, a sonographic evaluation of fetal fat body mass, however, can be considered as an effective, noninvasive and cost-effective method that can prove useful for evaluating the fetal consequences of maternal hyperglycemia.