title: Prediction of macrosomia by serial sonographic measurements of fetal soft-tissues and the liver in women with pregestational diabetes.
abstract: OBJECTIVE
  This study aimed to determine whether antenatal ultrasound measurements of fetal soft-tissues and liver can predict macrosomia in women with pregestational diabetes.
  
  
  METHODS
  Fetal biometry, soft-tissue thickness (anterior abdominal wall [STAW], thigh [STT], upper arm [STA], scapular [STS]) and liver size were measured sonographically at 23, 28, 31 and 34 weeks of gestation. Large for gestational age (LGA) was defined as a birth weight greater than 90th percentile for gestational age on standard curves adjusted for maternal height and weight, parity and fetal gender. The area (±standard error) under receiver operating characteristic (AUROC) curves were also calculated.
  
  
  RESULTS
  A total of 29 pregnant women with pregestational diabetes were included, and a total of 663 measurements taken. Fifteen neonates were LGA. There was no significant difference in fetal soft-tissue thickness at 23, 28 and 31 weeks between the LGA and non-LGA neonates. In contrast, at 34 weeks, fetal soft-tissues were significantly thicker in LGA neonates (P<0.05), but with no difference in liver surface area between the two groups. The specificity and sensitivity of 34-week ultrasonography to detect macrosomia was 78.6% and 66.7%, respectively, for abdominal circumference (AC), 71.4% and 93.3% for STT, 85.7% and 80.0% for STA, and 71.4% and 86.7% for STAW. No parameter was more powerful than the others. The best AUROC curves were found for AC (0.807), STT (0.821), STA (0.855) and STAW (0.821).
  
  
  CONCLUSIONS
  Third-trimester sonographic measurements of fetal soft-tissue may help to detect macrosomia in pregnancies complicated by pregestational diabetes.
authors: Pôle d'obstétrique, maternité Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille, France. Electronic address: charles.garabedian@gmail.com.
authors: C
authors: C
authors: Garabedian
authors: A
authors: A
authors: Vambergue
authors: J
authors: J
authors: Salleron
authors: P
authors: P
authors: Deruelle
mesh_terms: D034861:Abdominal Wall / Q000000981:diagnostic imaging / Q000196:embryology; D000328:Adult; D001132:Arm / Q000000981:diagnostic imaging / Q000196:embryology; D003922:Diabetes Mellitus, Type 1 / Q000000981:diagnostic imaging; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging; D016640:Diabetes, Gestational / Q000000981:diagnostic imaging*; D005260:Female; D005320:Fetal Macrosomia / Q000000981:diagnostic imaging*; D005333:Fetus / Q000648:ultrastructure*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000196:embryology*; D010298:Parity; D011237:Predictive Value of Tests; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D012372:ROC Curve; D012540:Scapula / Q000000981:diagnostic imaging / Q000196:embryology; D013848:Thigh / Q000000981:diagnostic imaging / Q000196:embryology; D016216:Ultrasonography, Prenatal
keywords: Diabetes mellitus; Foie; Grossesse; Liver; Macrosomia; Macrosomie; Pregnancy; Soft-tissues; Tissus mous; Ultrasonography; Échographie