Reference range of fetal gastric parameters using three-dimensional ultrasound VOCAL technique and significance in hyperglycemia in pregnancy: a prospective cross-sectional study.

OBJECTIVE

To establish reference ranges for fetal gastric parameters via two-dimensional (2D) and three-dimensional (3D) ultrasound virtual organ computer-aided analysis (VOCAL) technology and assess fetal gastric development and function in normal and hyperglycemia in pregnancy (HIP) cases.

METHODS

A prospective cross-sectional study was conducted with 457 normal fetuses (11-40 gestational weeks) via 2D and 3D ultrasound VOCAL techniques to measure gastric parameters (maximum length, transverse diameter, anteroposterior diameter, circumference, area, and volume) and calculate the gastric circumference-to-abdominal circumference (GC/AC), gastric area-to-abdominal area (GA/AA), and gastric emptying rate (GER). Nomograms were developed according to gestational age (GA). Intra- and inter-observer reliability were assessed in 50 randomly selected cases. Additionally, 126 HIP cases (90 well-controlled, 36 poorly-controlled) were analyzed via these nomograms.

RESULTS

Comprehensive nomograms for 2D and 3D gastric parameters were established. The gastric dimensions (maximum length, transverse diameter, anteroposterior diameter, circumference, area, and volume) and GER increased with increasing GA (p < 0.05), whereas the GC/AC and GA/AA ratios were not correlated (p > 0.05). The measurements revealed high intra- and inter-observer reliability. Compared with both the well-controlled HIP and normal groups, the poorly-controlled HIP group had significantly greater gastric parameters and lower GERs (p < 0.05), with no significant differences between the well-controlled HIP and normal groups (p > 0.05). Both HIP groups had lower GC/AC and GA/AA ratios than that in the normal group (p < 0.05), with significant differences between the poorly-controlled and well-controlled HIP groups (p < 0.05).

CONCLUSIONS

Fetal gastric parameter nomograms using 2D and 3D ultrasound VOCAL technology provide valuable tools for assessing fetal gastric development and function in normal and HIP pregnancies, highlighting the impact of glycemic control.