The Role of Umbilical Cord Thickness in Prediction of Fetal Macrosomia in Patients With Gestational Diabetes Mellitus
Condition: Gestational Diabetes
MeSH terms: Diabetes, Gestational; Fetal Macrosomia; Diabetes Mellitus
Study type: Observational

Summary: 
      The aim of this work is the prediction of fetal macrosomia by measuring:

        1. HbA1C.

        2. Umbilical cord thickness.

        3. Interventricular septum thickness.
    

Detailed description: 
      This prospective case control study will be carried out at Ain shams university maternity
      hospital between April 2015 and October 2015 on 80 patients. The patients will be divided
      into two groups, 40 pregnant women as case group with gestational diabetes mellitus and 40
      non diabetic pregnant women as control group after being approved by the local hospital
      ethics and research committee. A verbal consent will be taken from each patient.

      The following investigation will be performed:

        1. Calculation of gestational age will be based on the last reliable menstrual period or
           ultrasound examination within the first trimester.

           The ultrasound examination will be with Voluson E6 equipped with a 3.5 Hz
           trans-abdominal probe at fetal medicine unit of maternity hospital Ain Shams University.

        2. Ultrasound examination will be performed twice at 27-28 weeks and 36-37 weeks of
           gestation prospectively.

           During ultrasound, fetal biometry (biparietal diameter, abdominal circumference, femur
           length) and estimated fetal weight will be calculated automatically according to
           hadlock's formula additionally, the sonographic cross sectional area of umbilical cord,
           the umbilical arteries and umbilical vein will be measured in a free loop of the
           umbilical cord using the software of the ultrasound device.

           The cross sectional area of Wharton's jelly will be computed by subtracting the cross
           sectional area of the vessels from that of the umbilical cord and the interventricular
           septum thickness will be measured.

        3. HbA1c levels will be measured for diabetes patients.

      All the patients will be subjected to :

        1. Full history taking including last menstrual period, medical history and past obstetric
           history.

        2. Detailed general physical history examination and obstetrics examination.

        3. Ultrasound examination in fetal medicine unit maternity hospital Ain shams university.

        4. Venous blood samples will be taken from patients with gestational diabetes mellitus in
           clinical pathology department Ain Shams University, to measure the level of HbA1c using
           immunoassay technique. The patients will be followed up till delivery. The neonates will
           be weighed and fetal macrosomia will be diagnosed if fetal weight is 4 kg or more.
    

Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        This prospective case control study will be carried out at Ain shams university maternity
        hospital between April 2015 and October 2015 on 80 patients. The patients will be divided
        into two groups, 40 pregnant women as case group with gestational diabetes mellitus and 40
        non diabetic pregnant women as control group after being approved by the local hospital
        ethics and research committee. A verbal consent will be taken from each patient.