New measurement indicator of ultrasound assessment of the fetal pancreas based on anatomical landmarks and its application to fetuses with gestational diabetes mellitus

Abstract Objectives To assess the best method for measuring the fetal pancreas, provide nomograms and evaluate the effect of GDM on it. Methods A total of 271 singleton fetuses (17–36 weeks) were included in this study. Measurements of pancreatic parameters established reference ranges. Repeatability and consistency analyzed. GDM impact on fetal pancreatic growth assessed. Results Measurements of fetal pancreatic parameters fell within the 95 % confidence interval when performed by the same or different physicians. Pancreatic midline longitudinal axis demonstrated the best intraclass correlation coefficients (ICC) and follow by the pancreatic circumference. The successful display rate and measured parameters of the integral fetal pancreas achieved 90.3 %. Pancreatic midline longitudinal axis and circumference increased with gestational age, with significant differences observed among fetuses at different gestational ages (F=2060 and F=2264, p<0.05). Pancreatic midline longitudinal axis and circumference in normal fetuses from 17 to 36 weeks of gestation were positively correlated with gestational age and abdominal circumference. Poorly controlled GDM fetuses exhibited significantly larger pancreatic midline longitudinal axis and circumference compared to the normal group fetuses (Z-values were −3.82 and −3.77, both p<0.01), while no significant differences were found between well-controlled GDM group fetuses and normal group fetuses (Z-values were −0.59 and −0.042, both p>0.05). Conclusions Ultrasound method using anatomical landmarks to measure the fetal pancreatic midline longitudinal axis and circumference is reliable. Pancreatic measurements increase with gestational age. Poorly controlled gestational diabetes can lead to enlargement of the fetal pancreas.