Ultrasonographically Estimated Fetal Growth During the Third Trimester of Pregnancy and Maternal Glucose Tolerance Test in the Second Trimester

  • Dr Atsushi Yoshida, Department of Obstetrics and Gynecology, Nishisaitama-Chuo National Hospital, Japan
  • Dr Kenji Ishii, Department of Obstetrics and Gynecology, Nishisaitama-Chuo National Hospital, Japan
  • Dr Kazuya Kudo, Department of Obstetrics and Gynecology, Nishisaitama-Chuo National Hospital, Japan
  • Dr Keiko Saito, Department of Obstetrics and Gynecology, Nishisaitama-Chuo National Hospital, Japan
  • Dr Isao Azuma, Department of Obstetrics and Gynecology, Nishisaitama-Chuo National Hospital, Japan
  • Dr Manabu Narimiya, Department of Internal Medicine, Nishisaitama-Chuo National Hospital, Japan

    • Objective: We studied the difference in the ultrasonographically estimated fetal growth (UEFG) during the third trimester of pregnancy between the group with maternal glucose tolerance test in the second trimester and the group without the screening test.
    Methods: In 774 pregnant women, glucose tolerance screening test was performed between 24 and 29 weeks of pregnancy (S(+) group). In this group, occasional blood glucose (OBG) test was carried out and those who showed OBG>100mg/dL took 75g oral glucose tolerance test. In 123 pregnant women, glucose tolerance screening test was not done (S(-) group). In all of these 897 pregnant women, ultrasonographical estimation of fetal weight was made in the second trimester. We defined the UEFG as follows: UEFG = [birth weight] – [estimated fetal weight (EFW) in the second trimester]. The estimation of fetal weight was made with the formula by Japan Society of Ultrasound in Medicine (EFW=1.07 x BPD^3 + 0.3 x AC^2 x FL).
    Results: In S(-) group, the weekly UEFG rate was significantly greater than that of S(+) group. In S(-) group, the rate of over-weight neonates (>+1.5 SD) was also significantly larger than that of S(-) group.
    Conclusion: It was suggested that the implementation of the screening test using maternal glucose tolerance in the second trimester might have some effects on the fetal growth. We speculate that in S(-) group, patients’ nutritional guidance and interest in the proper diet were inadequate, which might have caused fetal overgrowth in some cases.