Ultrasonographic Evaluation of Fetal Liver, Pancreas, Thymus, and Adrenal Glands in Diabetic Versus Non‐Diabetic Pregnancies

OBJECTIVE: The aim of this study was to compare ultrasonographic measurements of selected fetal organs in diabetic pregnancies with non-diabetic pregnancies and to evaluate their potential as markers of fetal metabolic changes. METHODS: This prospective comparative observational study included 143 singleton pregnancies (73 with DM and 70 with normal glucose tolerance) between 20 and 39 weeks of gestation. Ultrasonographic measurements of fetal liver length, pancreas size, adrenal gland size, thymus size, and placental thickness were obtained. Measurements were standardized as Z-scores and correlated with maternal glycemic parameters. RESULTS: Fetal liver length (50.20 ± 12.44 vs. 37.24 ± 6.25 mm, p < 0.0001), pancreas circumference (10.62 ± 3.04 vs. 8.10 ± 2.06 cm, p < 0.0001), adrenal gland circumference (5. 58 ± 1.52 vs. 4.81 ± 1.03 cm, p = 0.0004), and placental thickness (45.78 ± 10.58 vs. 36.45 ± 5.48 mm, p < 0.0001) were significantly increased in diabetic pregnancies. Organ measurements were significantly positively correlated with HbA1c and fasting glucose levels. Multiple logistic regression analysis identified fetal liver length as the strongest independent predictor of maternal diabetes (OR: 11.797, 95% CI: 2.875-48.405, p = 0.001). CONCLUSION: Maternal diabetes is associated with selective enlargement of fetal metabolic organs. These ultrasonographic findings may serve as valuable non-invasive markers to identify fetuses at risk of in utero metabolic alterations in pregnancies complicated by diabetes mellitus.