Role of ultrasonographic measurement of the fetal epicardial fat pad and cardiac interventricular septal thickness in predicting the outcome and prevent various complications of gestational diabetes mellitus

Abstract

Background

Gestational diabetes mellitus (GDM) is one of the most common medical conditions affecting pregnancy and increasing the risk for maternal and perinatal complications. The present study aimed at determining the role of ultrasonographic measurement of fetal epicardial fat pad thickness (f EFT) and fetal cardiac interventricular septal thickness (f IVST) at 24–32 weeks of gestation in the prediction of GDM.

Results

A prospective observational case–control study was conducted including a total of 35 GDM patients and 35 normal pregnancies who were subjected to ultrasonographic measurement of the f EFT and f IVST at 24–32 weeks of gestation. Statistical analysis and the receiver operating characteristic curves were used to find out the cutoff value, sensitivity, specificity and diagnostic accuracy of these two parameters for the prediction of GDM. When an f EFT value of 1.3 was accepted as a cutoff value, GDM could be predicted with a sensitivity of 68.6% and specificity of 91.4%, PPV of 88.9%, NPV of 74.4% and diagnostic accuracy of 80%. When an f IVST value of 2.6 was accepted as a cutoff value, GDM could be predicted with a sensitivity of 80%, specificity of 77.14%, PPV of 77.8%, NPV of 79.4% and diagnostic accuracy of 78.5%.

Conclusion

The ultrasonographic measurements of fetal epicardial fat pad thickness and fetal cardiac interventricular septal thickness were statistically significantly higher in GDM pregnancies (p value < 0.0001) as compared to the controls. Thus, these two parameters can serve as excellent ultrasonographic markers in the prediction of GDM.