Fetal growth restriction in gestational diabetes mellitus: from pathogenesis to management tactics

DOI

https://dx.doi.org/10.18565/aig.2024.81

Ignatko I.V., Alieva F.N., Churganova A.A., Rodionova A.M., Romanova E.M., Usman Yz Y., Anokhina V.M., Cherkashina A.V.
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia

This review presents the new scientific data on the development of placenta-associated complications, in particular fetal growth restriction (FGR), in pregnant women with gestational diabetes mellitus (GDM). GDM is associated with a large number of complications for both mother and fetus. Moreover, it increases the risk of miscarriage and preterm labor, pre-eclampsia, placental abruption, HELLP syndrome, preterm rupture of membranes and cesarean section. GDM can lead to later maternal complications such as type 2 diabetes mellitus (type 2 DM) and cardiovascular diseases. In addition to unfavorable outcomes for the mother, GDM has a negative impact on the fetus: it leads to diabetic fetopathy, congenital malformations, stillbirth, respiratory/cerebral distress syndrome of the newborn, etc. Although fetal macrosomia is a widely recognized consequence of GDM, babies with FGR are also born in GDM, and such pregnancies have a higher risk of adverse outcomes. This review presents the results of studies proving the possibility of FGR development in GDM and the characteristics of its pathophysiology, data on histologic changes in the placental tissue. The paper demonstrates the significance of lipid profile disorders in pregnant women with GDM in the pathogenesis of fetal growth abnormalities and FGR development. This study examines the characteristics of the hemostasis system in cases of FGR in women with GDM, the possibilities of prenatal diagnosis, including ultrasound, and the role of biochemical markers. The modern approach to managing pregnancy and labor in women with GDM and FGR is considered.
Conclusion: Further study of the pathophysiologic basis of placenta-associated complications of pregnancy, including FGR in women with GDM is necessary because it will contribute to the development of new preventive, diagnostic, and therapeutic strategies.

Authors’ contributions: Ignatko I.V., Churganova A.A., Rodionova A.M. – developing the concept and design of the study, analysis of the literature data, editing the text; Alieva F.N., Romanova E.M., Usman Yz Y., Anokhina V.M., Cherkashina A.V. – search and analysis of the literature data, writing the text.
Conflicts of interest: Authors declare lack of the possible conflicts of interest.
Funding: The study was carried out without sponsorship.
For citation: Ignatko I.V., Alieva F.N., Churganova A.A., Rodionova A.M., Romanova E.M., Usman Yz Y.,
Anokhina V.M., Cherkashina A.V. Fetal growth restriction in gestational diabetes mellitus:
from pathogenesis to management tactics.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (8): 14-23 (in Russian)
https://dx.doi.org/10.18565/aig.2024.81

gestational diabetes mellitus

fetal growth restriction

biochemical markers

ultrasound diagnostics

perinatal outcomes

Full text (in Russian)

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Received 08.04.2024

Accepted 30.07.2024

Irina V. Ignatko, Dr. Med. Sci., Corresponding Member of the Russian Academy of Sciences, Professor of the Russian Academy of Sciences, Professor, Head of the Department of Obstetrics, Gynecology and Perinatology of the N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8-2, +7(910)461-73-02, ignatko_i_v@staff.sechenov.ru,
https://orcid.org/0000-0002-9945-3848
Fatima N. Alieva, PhD student at the Department of Obstetrics, Gynecology and Perinatology of the N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8-2, +7(926)389-70-62, fatima1alieva@gmail.com, https://orcid.org/0000-0002-7651-4986
Anastasia A. Churganova, PhD, Associate Professor at the Department of Obstetrics, Gynecology and Perinatology of the N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8-2, +7(903)742-50-64, churganova_a_a@staff.sechenov.ru, https://orcid.org/0000-0001-9398-9900
Alexandra M. Rodionova, PhD, Associate Professor at the Department of Obstetrics, Gynecology and Perinatology of the N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8-2, +7(962)920-77-96, rodionova_a_m@staff.sechenov.ru, https://orcid.org/0000-0002-9170-9597
Ekaterina M. Romanova, PhD student at the Department of Obstetrics, Gynecology and Perinatology of the N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8-2, +7(926)315-05-57, ВР1178915@yandex.ru, https://orcid.org/0009-0005-0194-9300
Yahaya Usman Yz, PhD student at the Department of Obstetrics, Gynecology and Perinatology of the N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8-2, +7(924)542-52-80, yzee12588@gmail.com, https://orcid.org/0009-0005-0835-8394
Valeria M. Anokhina, 6th year student at the Department of Obstetrics, Gynecology and Perinatology of the N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8-2, +7(926)662-62-82, valeriia.anockhina@gmail.com, https://orcid.org/0000-0002-0401-3023
Anna V. Cherkashina, 5th year student at the Department of Obstetrics, Gynecology and Perinatology of the N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8-2, 7(910)009-81-63, cherkashina_a_V@student.sechenov.ru, https://orcid.org/0000-0002-3840-1948
Corresponding author: Irina V. Ignatko, ignatko_i_v@staff.sechenov.ru

Fetal growth restriction in gestational diabetes mellitus: from pathogenesis to management tactics

Ignatko I.V., Alieva F.N., Churganova A.A., Rodionova A.M., Romanova E.M., Usman Yz Y., Anokhina V.M., Cherkashina A.V.

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