The Role of Prenatal Target Ultrasonography in the Diagnosis of Congenital Anomalies in Infants of Diabetic Mothers.
- Author:
Young A KIM
1
;
Gina LIM
;
Byong Sop LEE
;
Jae Yoon SHIM
;
Hye Sung WON
;
Ellen Ai KIM
;
Ki Soo KIM
;
Pil Ryang LEE
;
Ahm KIM
;
Soo Young PI
Author Information
1. Department of Pediatrics, University of Ulsan College of Medicine, Seoul, Korea. mdleebs@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Infants of diabetic mothers;
Prenatal ultrasonography;
Congenial abnormalities;
Gestational diabetes
- MeSH:
Collodion;
Congenital Abnormalities;
Diabetes, Gestational;
Echocardiography;
Fasting;
Female;
Glucose;
Humans;
Incidence;
Infant;
Insulin;
Mass Screening;
Medical Records;
Mothers;
Parturition;
Physical Examination;
Pregnancy;
Retrospective Studies;
Risk Factors;
Ultrasonography, Prenatal
- From:Korean Journal of Perinatology
2010;21(3):240-247
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: Infants of diabetic mothers have higher incidence of congenital malformations compared with those of non-diabetic mothers. We investigated the usefulness of prenatal level II or "targeted" ultrasonography (TUS) as a diagnostic tool to identify congenital abnormalities in infants of diabetic mothers. METHODS: We retrospectively reviewed the medical records of 218 mothers diagnosed as pregestational or gestational diabetes in whom prenatal TUS was performed in Asan Medical Center between 2004 and 2009. The prenatal TUS findings were compared with the congenital abnormalities found in the infants (n=226) of the diabetic mothers by physical examination and ultrasonography (including echocardiography). Maternal risk factors associated with congenital anomalies were also investigated. RESULTS: The incidence of congenital anomalies was 14.2% (n=32) in prenatal TUS and 15.5% (n=35) postnatally, respectively. Only 7 cases (3.6%) out of the 194 infants with normal prenatal TUS findings were found to have congenital abnormalities diagnosed postnatally. All of the abnormalities in these 7 infants could be detected or suspected by physical examination after birth. Maternal fasting glucose level >120 mg/dL and insulin therapy were significant risk factors for predicting congenital abnormalities in infants of diabetic mothers. CONCLUSION: Prenatal TUS performed by experienced obstetricians had a good reliability in the diagnosis of congenital anomalies in infants of diabetic mothers. Need for universal screening of ultrasound or echocardiography in these infants should be questioned especially in the cases in which prenatal TUS was performed.
