الفهرس 
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Abstract
In pregnancies complicated by diabetes mellitus, fetal macrosomia is common. For the mother the risks associated with increase rate of caesarean delivery, postpartum haemorrhage and perineal lacerations; Antenatal prediction of fetal macrosomia helps for identifying this high risk group so, several studies of ultrasound measurement for predicting of fetal macrosomia were performed. Abnormal weight gain in the uterus is correlated with raised rate of fetal morbidity and mortality. Also, it may have an adverse influence on health in childhood and adult life. Studies show that macrosomic infants have a higher risk of developing obesity and metabolic disorders. as it was observed that children with macrosomia tend to gain weight faster than those born at normal weight. The aim of the current study was: to evaluate the accuracy of the ultrasonographic measurement of the thickness of umbilical cord and fetal heart interventricular septum in pregnant women with and without gestational diabetes mellitus as a predictor for fetal macrosomia to minimize maternal and neonatal morbidity. This prospective comparative case - control study was carried out, including 124 pregnant women at 28-36 weeks of gestation that were recruited from in patient ward or those attending the obstetrics outpatient clinics of Tanta University Hospitals for routine pre-natal care. They were divided into two equal groups according to plasma glucose levels: group A (study group) : 62 pregnant women with gestational diabetes mellitus. group B (control group) : 62 euglycemic pregnant women All the participating women were subjected to clinical examination and laboratory investigations. Sonographic measurement of the fetal biometry, fetal weight, umblical cord diameter and interventricular septum thickness of the fetal heart were performed at 28-32 and 33-36 weeks. The cases were followed till delivery and mode of delivery were recorded, the neonatal birth weight were measured and compared with the previous sonographic predictor markers measurement. The main findings of the present study revealed that: There was no significant difference between both groups as regard to demographic characteristics. There were high statistically significant difference between both groups as regard to fasting plasma glucose, HbA1c and postprandial plasma glucose levels. Ultrasonographic measurement of the mean diameter of umbilical cord were statistically significant larger in the diabetic women group than the non diabetic group. Also, it was found that increase the interventricular septal thickness were statistically significant in gestational diabetic cases than the non diabetic women. In spite of presence of increase fetal growth in some cases of non diabetic group but statistically there were high significant difference between both groups regarding to increase both Umbilical cord diameter and IVS thickness and fetal overgrowth and neonatal macrosomia. Also, it was observed that increase the thickness of the interventricular septum was more correlated to fetal overgrowth and macrosomia than the umbilical cord diameter measurement and HbA1c. So, the current research denotes that it may be a value to integrate the thickness of both fetal heart IVS and umbilical cord indices to predict possible pathological macrosomia development in pregnant women either with gestational DM or not.