The value of mid-trimester fetal liver length measurement in prediction of gestational diabetes in Iraqi women

Abstract

Background. Gestational diabetes (GD) is a hyperglycaemic state specific to pregnancy. A well-tolerated, quick and minimally-invasive method for the early detection of GD in pregnancy is lacking.

Objective. To evaluate the correlation between the mid-trimester length of the fetal liver and GD.

Methods. A prospective study was conducted at the National Endocrine and Diabetic Center, College of Medicine, Al-Mustansiriya University, Iraq and the Obstetric and Gynecological Department at Al-Yarmouk Teaching Hospital, Iraq, from September 2016 to September 2018. One-hundred-and-twenty singleton pregnant women at high risk for gestational diabetes mellitus (GDM) were recruited. An ultrasound scan was performed at 23 weeks’ gestation followed by a 75 g oral glucose tolerance test (OGTT) at 24 weeks. A correlation was assessed between the mid-trimester fetal liver length (FLL) measurement and the OGTT.

Results. Mean (SD) FLL values were significantly higher among GDM patients v. healthy pregnant females respectively: 37.2 (3.4) v. 33.1 (2.7); p<0.001. Univariate analysis showed that FLL in GDM group was 1.6 times the non-GDM group (odds ratio (OR) 1.6; 95% confidence interval (CI) 1.31 - 1.96). There was no significant change after adjustment for parity and cumulative risk factors. Based on the above, FLL is an independent predictor for GDM (OR 1.6; 95% CI 1.30 - 1.96; p<0.05). 

Conclusion. FLL measurement by ultrasound at 23 weeks’ gestation is a feasible alternative to OGGT for the early detection of GDM in high-risk patients