Ultrazvučna procjena fetalne mase u trudnoćama opterećenima dijabetesom

master's thesis

• Title (english): Ultrasound assessment of fetal weight in pregnancies burdened by diabetes
• Author: Tea Tuškan
• Mentor: Josip Juras (mentor)
• Committee member: Vito Starčević (predsjednik povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Committee member: Josip Juras (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Gestacijski dijabetes melitus je opisan kao prolazni oblik dijabetesa izazvan inzulinskom rezistencijom i disfunkcijom β-stanica gušterače tijekom trudnoće, koji se prvi put javlja ili prvi put dijagnosticira u trudnoći. Dijabetes u trudnoći značajno ugrožava zdravlje majke povećanjem rizika razvoja preeklampsije, zatim oštećenjem endotelnih stanica predisponira majku na razvoj kardiovaskularnih bolesti i povećava rizik od nastanka dijabetesa melitusa tipa 2 kasnije u životu. Kod fetusa dolazi do mogućnosti razvoja makrosomije tijekom trudnoće, zatim respiratornog distres sindroma i hipoglikemije nakon porođaja. Makrosomija je definirana kao fetalna masa veća od 4 000 g ili 4 500 g, bez obzira na gestacijsku dob. Potrebno je na vrijeme prepoznati rizične čimbenike razvoja makrosomije, kako bi se na njih moglo utjecati. Trenutno se fetalna masa procjenjuje formulama koje koriste biometrijske parametre (biparijetalni promjer, opseg abdomena, opseg glave, duljina bedrene kosti) izmjerene ultrazvukom, no preciznost procjene pada sa porastom fetalne mase veće od 4 000g. Najčešće korištene formule za procjenu fetalne mase su Hadlock i Shepard, uz koje postoje još oko 30 drugih formula. Međutim, ni jedna nije dovoljno precizna u slučaju razvoja makrosomije. Točna dijagnoza makrosomije se može postaviti tek mjerenjem mase nakon porođaja. Sprječavanje komplikacija makrosomije se provodi dijagnosticiranjem i liječenjem gestacijskog dijabetesa melitusa.

Abstract (english)

Gestational diabetes mellitus has been described as a transient form of diabetes caused by insulin resistance and pancreatic β-cell dysfunction during pregnancy, which first occurs or is first diagnosed in pregnancy. Diabetes in pregnancy significantly endangers the mother's health by increasing the risk of developing preeclampsia, then by damaging endothelial cells predisposes the mother to the development of cardiovascular diseases and increases the risk of developing type 2 diabetes later in life. The fetus may develop macrosomia during pregnancy, followed by respiratory distress syndrome and postpartum hypoglycemia. Macrosomia is defined as a fetal weight greater than 4000 g or 4500 g, regardless of gestational age. Risk factors for macrosomia need to be identified on time so that they can be influenced. Currently, fetal weight is estimated using biometric parameters (biparietal diameter, abdominal circumference, head circumference, femur length) measured by ultrasound, but the accuracy of the estimate decreases with an increase in fetal weight greater than 4000 g. The most commonly used formulas for fetal weight assessment are Hadlock and Shepard, together with about 30 other formulas. However, none is precise enough in the case of the development of macrosomia. An accurate diagnosis of macrosomia can only be made by measuring weight after birth. Prevention of complications of macrosomia is carried out by diagnosis and treatment of gestational diabetes mellitus.

• Keywords: gestacijski dijabetes melitus; makrosomija; ultrazvučna procjena
• Keywords (english): gestational diabetes mellitus; macrosomia; ultrasound assessment
• Language: croatian
• URN:NBN: urn:nbn:hr:105:745315
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-03-20 09:28:33