First –trimester in comparison to second trimester detailed anomaly scan in diagnosis of fetal congenital anomalies in pregnant women with pregestational diabetes

Background: Pregestational Diabetes mellitus increases the risk of fetal congenital Structural abnormalities .
Ultrasonographic evaluation of a fetus of pregnant mothers.
With pregestational D.M can be done early in first trimester (starting from 11 weeks + 1 day) also in second trimester scan we can diagnose another abnormalities later in pregnancy.
Aim of the work : Assessment of the accuracy of first Trimester anomaly scan versus the second Trimester anomaly scan in Diabetic pregnant women. In diagnosis of fetal congenital anomalies.
Methods : 2D and 3 D Ultrasound was performed to 2500 pregnant women With pregestational D.M and to 300 pregnant women with no medical disorders both in first trimester(11weeks + 1 day ) And then in second trimester (at 18 weeks till 24 weeks) -Tei index (myocardial performance index) was also done HbA1c was done .
Results : Our study indicates a higher percent of congenital anomalies in diabetic pregnant Mothers than non diabetic pregnant women.
Conclusion: From our study, we concluded that 1st trimester scan offers an early noninvasive method of prenatal diagnosis of fetal congenital abnormalities. Especially 1st trimester scan, we can diagnose major brain anomalies (Anencephaly , Acrania), anterior abdominal wall defects (Gastroschisis, omphalocele) neural tube defects ( encephaloce) some renal anomalies (renal agenesis) But other structural fetal congenital anomalies needs a detailed 2nd trimester scan.