Umbilical vein blood flow in macrosomic fetuses with and without pre‐gestational diabetes: A cross‐sectional study
Menna H. Rakha, Amal Elshahat, Tamer Y. M. Ali, Noha al‐OkdaAbstract
Objective
This study compares umbilical venous blood flow ( Q UV ) in macrosomic fetuses with and without pre‐gestational diabetes (PGDM).
Methods
Seventy‐nine women with PGDM and fetal macrosomia were enrolled in this comparative cross‐sectional study (the PGDM group). A similar number of participants with fetal macrosomia and no diabetes constituted the control group. Fetal macrosomia was diagnosed antenatally based on increased ultrasound estimated fetal weight (EFW), symphysis‐fundal height measurement, or both and was confirmed retrospectively based on a birthweight ≥4000 g. All participants underwent an ultrasound examination between 36 and 37 weeks' gestation for EFW and Doppler assessment of the umbilical vein (UV).
Results
The UV diameter was significantly higher in the PGDM group compared to the control group, while no statistically significant difference was found in the time‐averaged maximum velocity (TAMXV). Both Q UV and Q UV corrected for EFW were significantly higher in the PGDM group compared to the control group. In addition to diabetes, increased neonatal birthweight and EFW were independently associated with a higher Q UV . Within the PGDM group, both UV diameter and Q UV were significantly higher in newborns with birthweights >4.5 kg in comparison to those ≤4.5 kg weight.
Conclusion
Q UV measured between 36 and 37 weeks' gestation is increased enhanced in fetuses with macrosomia and PGDM compared to those with macrosomia and no diabetes. This increase is attributed to a larger UV diameter rather than an increase in the TAMXV. This study highlights the difference in fetal hemodynamics between fetal macrosomia attributed to maternal PGDM and macrosomia related to other risk factors such as pre‐pregnancy obesity, increased gestational weight gain, or a previous macrosomic baby.