Fetal CPR at Term for Prediction of Adverse Neonatal Outcome in Pregnancies Complicated by GDM

Phase

N/A

Condition

Diabetes And Hypertension

Pregnancy Complications

Diabetes (Pediatric)

Treatment

Ultrasound

Clinical Study ID

NCT05852639

MD-329-2022

Ages 18-40
Female

Study Summary

The goal of this observational study is to evaluate fetal cerebroplacental ratio at term and its relation to adverse neonatal outcome in patients with gestational diabetes. The main question[s] it aims to answer are:

To evaluate the efficacy (sensitivity & specificity) of fetal cerebroplacental ratio at term in prediction of adverse neonatal outcome in pregnancies complicated by gestational diabetes
To evaluate the difference in fetal cerebroplacental ratio in patients treated by insulin & those on metformin
to evaluate the incidence of adverse neonatal outcome in patients treated by insulin & those on metformin.

Participants will undergo ultrasound and doppler study at 37 weeks & every two weeks thereafter till delivery. Neonatal assessment will be done after delivery to exclude adverse outcomes.

Eligibility Criteria

Inclusion

Inclusion Criteria:

Maternal age: 18-40 years
Diagnosed with gestational DM and are on insulin or metformin treatment.
Single living pregnancy.
Gestational age ≥ 37 weeks (confirmed by a reliable date for the last menstrual periodand 1st trimester ultrasound scan).

Exclusion

Exclusion Criteria:

Fetal anomalies.
Maternal chronic diseases esp. renal disease, epilepsy or CNS lesion.
Pregnancy induced medical disorders.
IUGR (EFW below the 10th percentile for gestational age).
Rupture of membranes or oligohydramnios (AFI < the fifth percentile).

Study Design

Ultrasound

November 30, 2022

April 30, 2024

Study Description

pregnant females in the reproductive age, pregnant ≥37 weeks, who were diagnosed with gestational diabetes by routine screening at 24-28 weeks, and are on metformin or insulin treatment. Informed consent, to share in the study, will be taken from all participants after describing the aim of the study and the potential hazards.

The patients enrolled in our study will be divided into two equal groups according to their treatment regimens:

(Group A): 130 patients who are on insulin treatment

(Group B): 130 patients who are on metformin

*All participants will be subjected to the following:

A) Full history taking:

Including personal, menstrual, obstetric, present, past & family history. B) Complete Physical Examination (general & local).

C) Investigations:

Routine baseline investigations:
1. Complete blood picture, Rh typing, liver & kidney functions.
2. HbA1C estimation.
3. Surveillance of maternal diabetes: daily fasting and 2- hour postprandial capillary glucose measurement.
4. Routine obstetric ultrasound will be done at term (at 37 weeks gestation): to confirm gestational age, assess fetal weight (EFW) and amniotic fluid index (AFI) and to exclude fetal anomalies.
Doppler ultrasonography assessment:

Doppler study and Cerebroplacental ratio assessment will be done at 37 weeks gestation and repeated every two weeks.To reduce inter-operator variability, a single experienced sonographer will perform all sonograms.

The mode of delivery and the gestational age at delivery will be noted

Early neonatal assessment:

1&5 minutes APGAR score
Neonatal blood glucose
Neonatal cord blood PH
The need for NICU admission

Connect with a study center

Kasr al-ainy hospital, Faculty of Medicine - Cairo University
Cairo, 11451
Egypt
Active - Recruiting

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