Association of umbilical coiling index with hypothyroidism and gestational diabetes mellitus.

Laily Najafi,1,* Mojtaba malek,2 Mohammad e. khamseh,3 Azadeh abedini,4

1. Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences
2. Research Center for prevention of cardiovascular disease, Institute of Endocrinology and Metabolism, Iran University of
3. Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences
4. Kamali Teaching hospital, Alborz University of Medical sciences

Abstract

Introduction

Gestational diabetes mellitus [gdm] and hypothyroidism are prevalent and potentially serious condition which may put mothers and fetuses at risk. coiling as a unique and obvious feature of the human umbilical cord is probably one of the most frequently reported umbilical cord related parameters in high risk pregnancies and fetal complications. ultrasonography evaluation of the umbilical coiling index [uci] could predict abnormal umbilical coiling index as a routine screening modality. this study was performed to compare antenatal umbilical coiling index in gdm and hypothyroidism with non-complicated pregnancy.

Methods

In our prospective study; a total of 212 parturients, were included; 102 gdm, 15 gdm/hypothyroidism, 15 hypothyroidism and 90 non-complicated pregnancy. gestational diabetes mellitus was confirmed for the parturients at 24-28 weeks of gestation. the venous sampling for thyroid function tests was performed at the first prenatal visit. an anatomical ultrasound survey of placenta and umbilical cord performed at 18-23 and 37-41 weeks of gestation (wg). the umbilical cord coiling was quantitatively assessed using uci. also the uci was evaluated postnatally. a postnatal uci was evaluated macroscopically within 24 hours after delivery.

Results

At 2nd trimester, the median and interquartile range(q1-q3)) of the uci in the 4 groups were as follows: gdm(0.23 (0.17, 0.34)), gdm/hypothyroidism(0.27 (0.22, 0.38)), hypothyroidism(0.33 (0.24, 0.41)) and non-complicated pregnancy(0.30 (0.20, 0.45)) respectively. this value at 3rd trimester was(0.21 (0.17, 0.32)) in gdm,(0.23 (0.20, 0.29)) in gdm/hypothyroidism,(0.33 (0.21, 0.45))in hypothyroidism and(0.26 (0.20, 0.34))in non-complicated pregnancy groups respectively. in postnatal macroscopic evaluation, the uci values in 4 groups were: gdm(0.18 (0.13, 0.26)), gdm/hypothyroidism(0.22 (0.16, 0.27)), hypothyroidism(0.23 (0.20, 0.33)) and non-complicated pregnancy(0.19 (0.15, 0.23)) respectively. a significant relationship was detected between 2nd trimester uci value of gdm group and non-complicated groups (p=0.007). a significant difference was found between uci value in gdm and hypothyroidism/non-complicated groups at 3rd trimester (p=0.023). no significant difference was found between groups in postnatal evaluation.

Conclusion

A significant relationship was detected between 2nd trimester uci value of gdm group and non-complicated groups. a significant difference was found between uci value in gdm and hypothyroidism/non-complicated groups at 3rd trimester. but no significant difference was found between groups in postnatal evaluation. overall, no significant association was found between hypothyroidism and uci in antenatal ultrasonographic and postnatal evaluation.

Keywords

Uci,gdm,hypothyroidism