Comparison of elasticity values in normal and gestational diabetic pregnancies in the third trimester

Abstract

Placental elasticity was compared by using Shear wave elastography (SWE) in patients with gestational diabetes mellitus (GDM) with and without insulin to non-diabetic controls. Three groups were created as follows: Group 1 (n = 79, GDM with insulin therapy), Group 2 (n = 90, GDM with only diet) and Group 3 (n = 150, healthy controls) All patients were above 36 gestational weeks with anterior placenta. Clinical trial number was also received (NCT04455880). Group 1 had higher BMI while group 3 had lowest rate of C/S. Birthweight in GDM groups was statistically significantly higher than controls (p = .001). Although there was no significant difference between APGAR scores, Group 1 had higher rates of neonatal intensive care unit (NICU) admission. SWE values were significantly higher in GDM patients treated with insulin or diet than controls. SWE may be an alternatively supplementary management modality in GDM.

IMPACT STATEMENT

• What is already known on this subject? Shear wave elastography (SWE), is one of the types of sono elastography methods that are used to measure the stiffness and elasticity of soft tissues. Recently, it became popular for screening the stiffness and elasticity of the placenta in high-risk pregnancies like preeclampsia, intrauterine growth restriction (IUGR), and placental dysfunction.

• What the results of this study add? All SWE velocities on the maternal side were statistically significantly different between groups. Regarding foetal side velocities, GDM groups had statistically significantly higher values (stiffer tissue) compared to controls.

• What the implications are of these findings for clinical practice and/or further research? SWE may be a Supplementary method in the diagnosis and management of GDM. Placental SWE should be measured at 24–28 weeks of gestation in patients with GDM and diagnosis confirmation and their responses to the treatment should be examined.

Keywords:

• Gestational diabetes mellitus
• high-risk pregnancy
• placental stiffness
• shear wave elastography
• third-trimester ultrasound

Disclosure statement

No potential conflict of interest was reported by the author(s).