Fetal Anomaly Detection in Pregnancies With Pregestational Diabetes

Area of Science:

• Medical Imaging
• Prenatal Diagnosis
• Diabetology

Background:

• Pregestational diabetes is a significant risk factor for fetal anomalies.
• Accurate prenatal detection of these anomalies is crucial for optimal neonatal outcomes.
• Sonographic evaluation plays a key role in identifying structural abnormalities.

Purpose of the Study:

• To assess the detection rates of fetal anomalies in pregnancies complicated by pregestational diabetes.
• To investigate the influence of gestational age, follow-up sonography, maternal body mass index, and affected organ systems on detection accuracy.
• To identify factors associated with improved or diminished fetal anomaly detection.

Main Methods:

• Retrospective analysis of pregnancies with pregestational diabetes from October 2011 to April 2017.
• Inclusion of pregnancies with at least one confirmed structural anomaly (EUROCAT classification).
• Evaluation of anomaly detection at initial detailed sonography (≥18 weeks gestation) and subsequent follow-up examinations.

Main Results:

• Overall fetal anomaly detection rate was 76% (55/72).
• Initial detailed sonography detected 68% of anomalies, while follow-up examinations detected 40%.
• Detection rates varied by organ system, with >85% for central nervous system, genitourinary, and musculoskeletal anomalies, and 65% for cardiac anomalies.

Conclusions:

• Approximately three-fourths of anomalous fetuses in pregnancies with pregestational diabetes were identified.
• Detection was significantly higher during the initial detailed sonographic examination compared to follow-up scans.
• Central nervous system, genitourinary, musculoskeletal, and certain cardiac anomalies were more readily detected.