| Objective To evaluate performances of the abdominal circumference, estimated fetal weight and the fetal fatty tissue in the prediction of birth weight≥90th percentile amongst women with gestational diabetes mellitus.Methods In a prospective study,a 2-h 75g oral glucose tolerance test was performed at 28-30 weeks of gestation.The GDM was diagnosesed by 1998 WHO criteria.Abdominal circumference(AC),estimated fetal weight(EFW),the area of humeral fatty tissue and the area of femur fatty tissue were regularly scanned by two-dimensional ultrasound at 4 weekly intervals onward from the third trimester to pre-delivery.Sensitivity,specificity,misdiagnostic rate,positive predictive value of the cut off value were then caculated for these parameters.Results 1.Prediction for LGA infants by AC is more accurate at 32,36 weeks of gestation than is before delivery.2.Prediction for LGA infants by EFW is more accurate at pre-delivery than is at 32,36 weeks of gestation.3.Prediction for LGA infants by fetal AC and EFW are more accurate than fetal fatty tissue.4.The area of humeral fatty tissue cannot predict LGA infants at 32 weeks of gestation,but it can predict LGA infants at 36 weeks of gestation and pre-delivery.The value of diagnosis efficiency is moderate and at pre-delivery is better than 36 weeks of gestation.5.The area of femur fatty tissue can predict LGA infants at 32,36 weeks gestation and pre-delivery,the value of diagnosis is moderate.Conclusions 1.Fetal AC and EFW measurements from 32 weeks of gestation to pre-delivery are useful for predicting LGA infants in diabetic pregnancies.2.Fetal fatty tissue has limited utility in the prediction of the LGA infants in diabetic pregnancies. |
