Assessment of liver stiffness by fibroscan in pregnant women of 1st trimester with pre gestational diabetes mellitus without known hepatic pathology for early diagnosis of liver disorders

This is an observational study using convenient sampling technique to observe the results of fibroscan on pre gestational diabetic women of 1st trimester without any known hepatic pathology. This study aims to assess the liver stiffness and its relation with insulin resistance using fibroscan as a non invasive diagnostic tool . The fetal and maternal outcomes will be studied and effects of altered fibroscan results on them.The first change that occurs in pregnant individuals with pre gestational diabetes mellitus is fall in fasting glucose levels , followed by insulin resistance and glucose intolerance potentially causing liver derived metabolic complications , complications like pre eclampsia, preterm birth and affect both fetal and maternal health.

Fibroscan is a diagnostic modality that uses transient elastography which  has 10 times smaller sampling error (3%) and

better inter observer reliability in contrast to liver biopsy.

The study will be conducted on pregnant women with pre gestational diabetes mellitus(PGDM) without known hepatic pathology in the first trimester of pregnancy attending the antenatal opd and wards of a tertiary health care centre. Since there is limited longitudinal data , further research is required to determine the specific contribution of insulin resistance to liver stiffness.

This study aims to study the risk posed by pre gestational diabetes mellitus in development and progression of liver disease in pregnant woman with emphasis on the potential role of fibroscan for early detetction of steatosis/ fibrosis in pregnancies complicated by pregestational diabetes mellitus.