Ultraschall in Med 2012; 33(7): E108-E113
DOI: 10.1055/s-0029-1245926
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Fetal Anterior Wall Thickness and Amniotic Fluid Insulin Levels: an Interdependence?

Fetale Bauchdeckendicke und Fruchtwasserinsulinspiegel: ein Zusammenhang?D. Ulrich1 , G. Desoye2 , C. Wadsack2 , J. Haas2 , B. Csapo2 , M. Holzapfel-Bauer2 , U. Lang2 , D. Schlembach2
  • 1Department of Obstetrics and Gynaecology, Medical University Graz
  • 2Prenatal Center Munich, Munich
Further Information

Publication History

received: 4.8.2010

accepted: 19.11.2010

Publication Date:
09 December 2011 (eFirst)

Zusammenfassung

Ziel: Die exzessive fetale Fettansammlung als Folge des fetalen Hyperinsulinismus ist eine der Komplikationen beim Gestationsdiabetes (GDM). Eine nicht invasive Methode für die fetale Überwachung beim GDM ist notwendig. Das Ziel dieser Studie war es, zu evaluieren, ob die fetale anteriore Bauchwanddicke (AAWT) eine frühe Prädiktion des Hyperinsulinismus mit Ultraschall ermöglicht. Material und Methoden: Bei 220 Frauen mit Gestationsdiabetes (diagnostiziert mit einem 75 g oGTT in der 24.–28. SSW) wurde zwischen der 28. und 32. Schwangerschaftswoche eine Amniozentese durchgeführt. Die Fruchtwasserinsulinwerte (AFIL) wurden mittels eines kommerziell erhältlichen Radioimmunoassays bestimmt. Die biometrischen Daten einschließlich des AAWT wurden mittels transabdominalen Ultraschalls ermittelt. Die maternalen Parameter (Gewicht, BMI, oGTT-Blutzuckerwerte sowie mittlere Blutglukosewerte) wurden mit den fetalen biometrischen Daten einschließlich AAWT und mit den AFIL-Werten korreliert. Ergebnisse: Die AAWT-Werte korrelierten nicht mit den AFIL-Werten. Es konnte auch keine Korrelation zwischen den AFIL-Werten und allen anderen fetalen Parametern wie auch mit den oGTT-Resultaten gezeigt werden. Die AFIL-Werte zeigten nur mit dem maternalen Gewicht (p = 0,02) und BMI (p = 0,01), sowohl vor der Schwangerschaft als auch zum Zeitpunkt der Amniozentese, eine signifikante Korrelation. Schlussfolgerung: AAWT-Messungen im frühen dritten Trimenon korrelieren nicht mit fetalen Insulinwerten.

Abstract

Purpose: Excessive fetal fat as the hallmark of GDM pregnancy complications is one consequence of fetal hyperinsulinism. Noninvasive methods for fetal surveillance and measurement of fetal fat are needed. The purpose of this study was to test the hypothesis that measurements of the fetal anterior abdominal wall thickness (AAWT) in women with GDM will allow early detection of fetal hyperinsulinism. Materials and Methods: Amniocentesis was performed between 28 and 32 weeks of gestation (wks) in 220 women with GDM (diagnosed by 75 g oGTT at 24 to 28 wks). Amniotic fluid insulin levels (AFIL) were determined by a commercially available radioimmunoassay. Transabdominal ultrasound provided fetal biometric measurements following standard procedures and the AAWT including fetal skin and subcutaneous tissue at the time of amniocentesis. Maternal parameters (weight, BMI, oGTT blood glucose levels and mean daily blood glucose levels) were correlated with fetal biometric data and with AFIL. Results: There was no difference in AAWT in women with GDM and no correlation with mean AFIL. AFIL also did not correlate with any other fetal measurement or with mean oGTT blood glucose levels. AFIL only showed a correlation with maternal weight (p = 0.02) and maternal BMI (p = 0.01). The correlation was present for values both before pregnancy and at the time of amniocentesis. Conclusion: In the early third trimester, AAWT measurements do not correlate with fetal insulin levels.

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Dr. Daniela Ulrich

Department of Obstetrics and Gynaecology, Medical University Graz

Auenbruggerplatz 14

8045 Graz

Austria

Phone:  ++ 43/65 07 51 49 06

Fax:  ++ 43/3 85 20 80

Email: danielau@a1.net