Estimation of Sonographic Umbilical Cord Area and Its Correlation with Birth Weight in Gestational Diabetes Mellitus.

  • Nidhi Jain
  • Abha Singh
Keywords: Umbilical cord, umbilical cord area, Gestational diabetes mellitus, macrosomia.

Abstract

Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance with its onset or first recognition during pregnancy. It is associated with various maternal and fetal complications which of which, macrosomia is the major challenging threat. Prediction of birth weight helps in timely decision and management of these women. A recent way to predict birth weight is by umbilical cord area estimation.Methods: A prospective cohort study including 50 women with GDM (group I) and 50 without GDM (group II) was conducted in a tertiary hospital over a period of 1 year, after clearance from Institutional Ethical Committee. Women in both groups were subjected to ultrasonographic examination at 30-32 weeks and subsequently at 36-38 weeks. At each examination, umbilical cord area (UCA) was measured in a free loop of umbilical cord. Birth weight of each baby was measured. Results: At 30-32 weeks, UCA was 239.7 mm2 in group I and 224 mm2 in group II, difference being statistically significant. At 36-38 weeks also, UCA was significantly larger in group I (250.1 mm2) than in group II (228.2 mm2). Correlation coefficient (r) between umbilical cord area and birth weight was 0.944 in group I and 0.796 group II at 30-32 weeks and at 36-38 weeks, 0.990 in group I and 0.530 in group II.Conclusions: A strong positive correlation exists between umbilical cord area and birth weight in women with gestational diabetes mellitus, thus it should be estimated during routine antenatal ultrasound for prediction of birth weight in these women.

References

1. Seshiah V, Balaji V, Balaji M, Panneerselvam A, Kapur A. Pregnancy and Diabetes Scenario around the World: India. Int J Gynaecol Obstet 2009; 104 (1): S35-8.
2. Seshiah V, Balaji V, Madhuri S Balaji, Panneerselvam A, Arthi T,Thamizharasi M et al. Prevalence of GDM in South India (Tamil Nadu) – A Community based study. JAPI 2008; 56: 329-33.
3. Zargar AH, Sheikh MI, Bashir MI, Masoodi SR, Laway BA, Wani AI et al. Prevalence of gestational diabetes mellitus in Kashmiri women from the Indian subcontinent. Diabetes Res Clin Pract. 2004; 66(2): 139- 45.
4. Grewal E, Kansra S, Khadgawat R, Kachhawa G, Ammini AC, Kriplani A et al. Prevalence of GDM among women attending a Tertiary Care Hospital AIIMS Presented at DIPSI 2009 and 5th DIP Symposium, Sorrento, Italy, 2009.
5. Singh Dorendra I, Devi Bidhumukhi Th, Devi Ibeyaima Kh, Singh Premchand Th. Scientific Presentation Volume of the First National Conference of the DIPSI, Chennai February 2006.
6. Yuvaraj M G. Data presented at the First National Conference of DIPSI: Chennai February 2006.
7. Swami SR, Mehetre R, Shivane V, Bandgar TR, Menon PS, Shah NS. Prevalence of Carbohydrate Intolerance of Varying Degrees in Pregnant Females in Western India (Maharashtra) - A Hospital-based Study. J Indian Med Assoc 2008; 106 (11): 712-4.
8. Divakar H, Tyagi S, Hosmani P, Manyonda IT. Diagnostic criteria influence prevalence rates for gestational diabetes: implications for interventions in an Indian pregnant population. Perinatology 2008: 10 (6); 155 – 61.
9. Martin J, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Kirmeyer S. Births: final data for 2004. Natl vital stat rep 2006; 55 (1): 1-101.
10. Milnerowicz-Nabzdyk E, Zimmer M, Tlolka J, Michniewics J, Pomorski M, Wiatrowski A. Umbilical cord morphology in pregnancies complicated by IUGR in cases of tobacco smoking and pregnancy-induced hypertension. Neuro Endocrinol Lett 2010; 31(6): 842-847.
11. Bankowski E, Sobolewski K, Romanowicz L, Chyczewski L, Jaworski S. Collagen and glycosaminoglycans of Wharton’s jelly and their alterations in EPH-gestosis. Eur J Obstet Gynecol Reprod Biol 1996; 66 (2): 109-117.
12. Weissman A, Jakobi P, Bronshtein M, Goldstein I. Sonographic measurements of the umbilical cord and vessels during normal pregnancies. J Ultrasound Med 1994; 13 (1): 11-14.
13. Barbieri C, Cecatti JG, Souza CE, Marussi EF, Costa JV. Sonographic measurement of the umbilical cord and the diameters of its vessels during pregnancy. Journal of Obsetetrics and Gynecology 2012; 32 (3): 230-236.
14. Weissman A, Jakobi P. Sonographic measurements of the umbilical cord in pregnancies complicated by gestational diabetes. J Ultrasound Med 1997; 16 (10): 691-694.
15. Binbir B, Ozgur Yeniel A, Ergenoglu A, Knzandi M, Akercan F, Sagol S. The role of umbilical cord thickness and HbA1c levels for the prediction of fetal macrosomia in patients with gestational diabetes mellitus. Arch Gynecol Obstet 2012; 285 (3): 635-639.
16. Predanic M, Perni S. Absence of a Relationship between Umbilical Cord Thickness and Coiling Patterns. J Ultrasound Med 2005; 24:1491–1496.
Published
2016-04-27
Section
Original Article