Role of Ultrasound Scan in Diabetic Pregnancy

Diabetes is one of the most common disorders complicating pregnancy, associated with negative outcomes for the fetus and newborn, including fetal congenital anomalies, stillbirth, and growth disorders. Ultrasonography (US) represents a noninvasive, readily available method to assess and monitor the fetus. US use in diabetic pregnancy is now widely consolidated, allowing early detection of congenital anomalies and assessment of fetal growth, in order to optimize timing and mode of delivery. More recently, the use of fetal ultrasound evaluations and measurements of growth has been encouraged in addition to maternal glycemic control in order to identify which fetuses are at increased or decreased risk for complications, so as to guide maternal therapy. The present chapter reviews the role of the ultrasound scan in the diabetic pregnancy, focusing on the use of US for the identification of congenital abnormalities, the estimation of fetal growth, and the possible benefit of modulating management of pregnant women with diabetes based on sonographic results. Future studies comparing management strategies that address optimal timing, frequency of ultrasound examinations, and glycemic targets are needed. Most importantly, future trials involving GDM pregnancies should examine the effects of in utero different managements and therapies on childhood and lifetime risks for developing obesity or impaired glucose tolerance.