[Fetal ultrasound biometry and amniotic fluid insulin concentration in pregnant diabetic patients].
OBJECTIVE
The aim of the study was to prove the sensitivity of sonographic measurements for the presence of a fetal hyperinsulinism.


METHODS
In a longitudinal examination of 102 insulin-dependent diabetics we show the correlation between the amniotic fluid insulin level and the biparietal diameter, abdominal diameter and femur length in the third trimester. The control of the maternal metabolic state was done by measuring the glycosylated hemoglobin and fructosamine at the time of the amniocentesis.


RESULTS
The sensitivity, specificity, positive and negative predictive value of sonographic measurements > 75th percentile in fetal hyperinsulinism was for the biparietal diameter 21, 96, 81 and 62%, for the abdominal diameter 48, 82, 69 und 66%, and for the femur length 22, 90, 67 and 57%. The maternal glycoproteins did not show any correlation with the amniotic fluid insulin level.


CONCLUSIONS
The results demonstrate that fetal hyperinsulinism cannot be proved by fetal biometry or evaluation of the maternal metabolic state.
Hüttner
U
U
Geburtshilflich-Gynäkologische Universitätsklinik Graz, Osterreich.
Kainer
F
F
Weiss
P A
PA
Haas
J
J
D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry*; D000886:Anthropometry; D003922:Diabetes Mellitus, Type 1 / Q000000981:diagnostic imaging*; D005260:Female; D005320:Fetal Macrosomia / Q000000981:diagnostic imaging*; D019270:Fructosamine / Q000032:analysis; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006946:Hyperinsulinism / Q000000981:diagnostic imaging*; D007231:Infant, Newborn; D007328:Insulin / Q000032:analysis*; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000000981:diagnostic imaging*; D012307:Risk Factors; D016216:Ultrasonography, Prenatal
D019270:Fructosamine; D006442:Glycated Hemoglobin; D007328:Insulin