Correlation of placental ultrasound elastography with perinatal outcomes in gestational diabetes mellitus.

Abstract

Purpose: To correlate placental ultrasound shear wave elastography (SWE) values with perinatal outcomes in Gestational Diabetes Mellitus (GDM).

Methods: The study included 160 pregnant women, comprising 80 GDM and 80 healthy controls. Ultrasound SWE was performed on the placenta, and mean SWE and velocity values were derived from six measurements. Both the cases and controls were followed to record Apgar scores and NICU admission. Statistical analysis was done, and the SWE values were compared to correlate these values with perinatal outcomes.

Results: A positive correlation was observed between SWE values and maternal fasting blood glucose (FBS) levels (rho = 0.32, p = 0.001), indicating that higher glucose levels are associated with increased placental stiffness. In the control group, the mean SWE was 2.48 kPa, while in the GDM group, it increased to 7.74 kPa, reflecting the impact of a diabetic environment on placental stiffness. The mean velocity was also higher in the GDM group (1.47 m/s) as compared to the control group (mean = 0.87 m/s). A moderate negative correlation between APGAR (1-min) and mean SWE was found at <32 weeks of gestation (rho = -0.48, p = 0.017). No significant correlation was found with NICU admissions.

Conclusion: Placental stiffness differs significantly between GDM and controls, with higher values in GDM. Ultrasound SWE can substantially contribute to the management of GDM and improve the outcomes. A negative correlation between SWE and 1-minute APGAR score at <32 weeks of gestation is associated with a lower score, indicating the effect of increased placental stiffness on perinatal outcomes.