Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A retrospective analysis of 646 Arab grandmultiparas who booked for hospital confinement at the King Abdul Aziz University Hospital in Riyadh, Saudi Arabia between 1983 and 1985 was carried out. Results were compared with that of nongrandmultiparas during the same period. In the grandmultiparas, the incidences of gestational diabetes, hypertension, rheumatic heart disease, antepartum, pospartum hemorrhage, and macrosomic infants were increased. However, contrary to some previous reports the incidences of anemia, cesariean sections, induced labor, dysmaturity and perinatal deaths were decreased. This is thought to be due to the provision of modern specialist perinatal care and improved socioeconomic standards. In communities where poor socioeconomic standards and inadequate health services still prevail, grandmultiparity is to be regarded as a risk factor associated with increased maternal and fetal morbidity and mortality. Under the improved conditions of present day obstetrics, including competent clinical staff, the grandmultipara faces the same risk to her life during pregnancy as the woman with lesser parity. The sample in this analysis ranged in age from 18 to 43 years with mean age at 33 years. 195 (30%) were older than 35 years. This is a similar age distribution to other centers in Saudi Arabia and in Malay and Indian grandmultipara of Singapore.
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PMID:The problem of grandmultiparity in current obstetric practice. 290 Jan 62

The authors have evaluated seven years' period of the intensive care of pregnant women suffering from diabetes mellitus. In the analysed period 175 patients suffering from diabetes gave birth to babies, and that was 0.69% of all the labours. The most frequent type of diabetes was gestational diabetes mellitus (53.7%), and diabetes of B type (23.5). Diabetes of G-1 type occurred in as many as 44% of the examined women. In the tested group of women the indication to conducting a cesarean section occurred in 16.6% of cases. It was found that the babies born by the mothers suffering from diabetes had in their early neonatal period the following biochemical disorders: hypoglycemia--37.7%, hyperbilirubinemia--17.4%, anemia--8.7% and hypocalcemia--5.8% of cases. Monitoring of pregnancy, the time and the way of its termination should be selected individually for each women suffering from diabetes mellitus.
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PMID:[Evaluation of a seven year period of managing pregnancies complicated by diabetes mellitus]. 857 79

In Saudi Arabia, pediatricians compared data on infants of 52 mothers who received insulin therapy during pregnancy (group A) with data on infants of 81 mothers who either did not receive insulin therapy during pregnancy or prenatal care (group B) to evaluate the outcome in infants of diabetic mothers (IDMs) managed at Qatif Central Hospital. These 133 IDMs comprised 1.14% of the 11,677 deliveries at this hospital during 1988-92. 19.7% of all mothers had gestational diabetes mellitus. Mothers in group A were younger than those in group B (31.5 vs. 35.1 years; p 0.01). They were less likely than those in group B to suffer fetal loss (23.1% vs. 53.1%; p 0.001 and [mean fetal loss] 0.62 vs. 1.33; p 0.05). All six stillbirths (2 in group A and 4 in group B) were large for gestational age (LGA) (4.543 vs. 3.753 kg for overall birth weight; p 0.001). One stillbirth was macerated and had multiple congenital anomalies including Down's syndrome. Two liveborn IDMs also had Down's syndrome. There were no early neonatal deaths. The perinatal mortality rate (PMR) was not significantly different between the groups, but the PMR for both groups was higher than it was for the same period for the hospital overall (45.1 vs. 16.6/1000; p 0.02). 57.9% of IDMs from both groups were LGA. 38.6% of all IDMs had a blood glucose level less than 30 mg/dl. Other problems identified in IDMs included bacterial infections, birth trauma, preterm delivery, respiratory distress, polycythemia, and anemia. These findings suggest that poor maternal diabetic control contributed to the high perinatal morbidity and mortality in IDMs. Health education and improved care of diabetic pregnant women are seriously needed.
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PMID:Perinatal morbidity and mortality in offspring of diabetic mothers in Qatif, Saudi Arabia. 873 Jun 18

The purpose of this study was to determine if early adolescence imparts a significant obstetric risk in young primiparas relative to adult primiparas. The records of 239 young primiparas (< 16 years) and 148 older primiparas (18-29 years) were reviewed for demographic information, antepartum complications, mode of delivery, length of labor, episiotomy, lacerations, birthweight, and length of gestation. The young adolescents were shorter, had an earlier age at menarche, a lower pregravid body mass index, and a higher gestational weight gain. The young teens were less likely to smoke cigarettes but were more likely to be Medicaid recipients. The incidence of most antenatal complications (chronic hypertension, pregnancy-induced hypertension, placental abruption, placenta previa, premature rupture of the membranes, urinary tract infections, and anemia) were similar between the two groups. Preterm labor and contracted pelvis were more common among the young adolescent, while gestational diabetes was less common. The young primiparas were significantly (P < .05) less likely to have a Cesarean delivery and to lacerate with vaginal delivery. The length of labor and its stages were similar, as were overall birthweight and length of gestation. Thus, obstetric concerns regarding pregnancy in early adolescence may be unfounded. With the exception of an increased risk for preterm labor, it appears that pregnancy, labor, and delivery do not pose inordinate obstetric and medical risk to the very young adolescent primipara.
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PMID:Pregnancy in early adolescence: are there obstetric risks? 897 10

The objective of this article is to describe maternal morbidity in a large cohort of triplet pregnancies managed by a single Maternal-Fetal Medicine group over a short period of time. Records from all triplet pregnancies managed and delivered from 1992 to 1996 were reviewed for maternal outcome data. Pregnancies delivered prior to 20 weeks were excluded. During the 4-year study period, 55 triplet pregnancies were managed and delivered at this center. The most common maternal complication was preterm labor, which occurred in 42 cases (76%). Preterm premature rupture of membranes occurred in 11 cases (20%). Pregnancy-induced hypertensive complications occurred in 15 cases (27%), which included severe preeclampsia 13 (24%), hemolysis, elevated liver function tests, and low platelets (HELLP) syndrome 5 (9%), and eclampsia 1 (2%). Other maternal antenatal complications included anemia 15 (27%), acute fatty liver of pregnancy 4 (7%), gestational diabetes 4 (7%), supraventricular tachyarrhythmias 2 (4%), dermatoses 2 (4%), urinary tract infection 2 (4%), and acute disc prolapse requiring surgery in 1 case (2%). Postnatal complications occurred in 18 cases (33%), including endometritis 13 (24%), postpartum hemorrhage 5 (9%), pneumonia 2 (4%), urinary tract infection 2 (4%), and diastasis of rectus muscles requiring surgery in 1 (2%). There were no maternal deaths. Antenatal and postnatal maternal complications occur in almost all triplet gestations, suggesting that such pregnancies be managed at centers that have appropriate multidisciplinary expertise available.
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PMID:Maternal morbidity associated with triplet pregnancy. 947 92

Successful pregnancy outcome is an uncommon occurrence in women requiring chronic dialytic treatment, and the most adequate dialysis therapy in the management of these pregnant patients has not been established. During the period 1988-1995, we studied the outcome of 17 pregnancies in dialyzed females, with an average age of 28.2 +/- 5.9 years (range: 18-38 years). Seven women had adequate urine volume (>800 ml/24 h). Five patients started dialysis after conception and the remaining 12 pregnancies were diagnosed after 6-72 months on dialysis. Fourteen women were maintained on hemodialysis (HD) and 3 on continuous ambulatory peritoneal dialysis (CAPD). The HD schedule was increased to 3 h 5-6 times weekly, and CAPD was increased to six 2-liter exchanges/day. Mean serum urea was 78.6 +/- 27.4 mg/dl (range 45-110); serum creatinine was 6.5 +/- 3.7 mg/dl (3.3-9.8 mg/dl); and hematocrit was 28.9 +/- 3.3 vol% (22-35 vol%). Anemia was partially controlled with rHuEpo in 8 patients. Significant problems were polyhydramnios in 7 cases (5 HD/2 CAPD), oligohydramnios in 1 (HD), gestational diabetes in 2 (CAPD), premature labor with spontaneous abortion at the 19th, 22nd and 28th weeks of gestation (2 HD/1 CAPD), hypertension in 8 (7 HD/1 CAPD), and sterile eosinophilic peritonitis in 1 case (CAPD). Mean gestational age at delivery in 14 successful pregnancies (12 HD/2 CAPD) was 32.3 +/- 2.6 weeks (27-36 weeks) and mean baby weight was 1,400.7 +/- 579.1 g (range 720-2,650 g). No congenital fetal abnormality was observed. Respiratory distress was observed in 6 infants, with 2 deaths (1 HD/1 CAPD) in the first week after delivery. In this study, successful pregnancies were reported in 70.6% of dialyzed women with uremia, with hemodialysis having a rate of fetal survival of 78.6% and CAPD with 33.3%.
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PMID:Pregnancy in women on chronic dialysis. A single-center experience with 17 cases. 958 May 42

Prenatal care has been implemented in developing countries according to the same mode as applied in industrialized countries without considering its real effectiveness in reducing maternal and neonatal mortality. Several recent studies suggest that the goals should be revisited in order to implement a program of prenatal care based on real scientific evidence. Based on the current literature, we propose a potentially effective content for prenatal care adapted to the context of developing countries. Four antenatal consultations would be enough if appropriately timed at 12, 26, 32 and 36 weeks pregnancy. The purpose of these consultations would be: 1) to screen for three major risk factors, which, when recognized, lead to specific action: uterine, scare, malpresentation, premature rupture of the membranes; 2) to prevent and/or detect (and treat) specific complications of pregnancy: hypertension, infection (malaria, venereal disease, HIV, tetanus, urinary tract infection); anemia and trace element deficiencies, gestational diabetes mellitus; 3) to provide counseling, support and information for pregnant women and their families (including the partner) concerning: severe signs and symptoms of pregnancy and delivery, community organization of emergency transfer, delivery planning. These potentially effective actions can only have a real public health impact if implemented within an organized maternal health system with a functional network of delivery units, if truly quality care is given, and if the relationships between health care providers and the population are based on mutual respect. Sub-Saharan African women use prenatal care extensively when it is accessible; this opportunity must be used to implement evidence-based actions with appropriate and realistic goals.
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PMID:[Potential role of prenatal care in reducing maternal and perinatal mortality in sub-Saharan Africa]. 1197 82

Considering that young women have a high risk of iron store deficiency, the iron supplementation is largely proposed during pregnancy. However, a selective supplementation reserved to anaemia women, must be preferred to a systematic supplementation which improves biological parameters of mothers but have no effect on newborns. Iron is a potentially toxic element and a not justified, supplementation could expose to high iron level and to an oxidative stress which is also observed in pregnancy pathologies (preeclamptia, gestational diabetes). Furthermore a non controlled increase of erythrocyte mass by iron supplementation could also alter the placenta exchange. As a precaution, iron supplementation may be reserved to anaemia women or with high anaemia risk. For others, nutritional advises must permit to reach iron recommendation.
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PMID:[Is systematic iron supplementation justified during pregnancy?]. 1512 24

Insulin resistance is a characteristic feature of obesity and type 2 diabetes mellitus, but it is also present in up to 25% of healthy nonobese individuals. The molecular mechanisms causing insulin resistance are not yet fully understood. Recently, overexpression of several potential inhibitors of the insulin receptor tyrosine-kinase activity, a key step in insulin signaling, has been described in insulin-resistant subjects . PC-1 is expressed in many tissues and inhibits insulin signaling either at the level of the insulin receptor or downstream at a postreceptor site. An elevated PC-1 content in insulin target tissues may play an important role in the development of insulin resistance in obesity and type 2 diabetes mellitus. A polymorphism in PC-1 has been demonstrated to be associated with insulin resistance. This was a DNA polymorphism in exon 4 that causes an amino acid change from lysine to glutamine at codon 121 (K121Q). PC-1 121Q allele might predispose independently of other well established risk factors for early myocardial infarction. Testing for the PC-1 K121Q polymorphism might be valuable in patients with a family history of atherosclerotic vascular disease and myocardial infarction. There is growing evidence that genetic factors play an important role in the development of diabetic nephropathy (DN). Efforts to identify these factors rely primarily on the candidate gene approach; candidate genes for insulin resistance may be considered candidates for DN as well. In a stratified analysis according to duration of diabetes, the risk of early-onset end-stage renal disease (ESRD) for carriers of the Q variant was 2.3 times that for noncarriers. The cellular mechanisms for the insulin resistance of pregnancy and gestational diabetes mellitus (GDM) are unknown. Women with GDM have an increased PC-1 content and excessive phosphorylation of serine/threonine residues in muscle insulin receptors. The postreceptor defects in insulin signaling may contribute to the pathogenesis of GDM and the increased risk for type 2 diabetes later in life. Although widely explored, the true cause of insulin resistance in uremic patients is not entirely elucidated yet. During the last decade it was found that erythropoietin (EPO) therapy, used for correction of anemia in patients with end stage renal failure, ameliorates insulin resistance. An increased lymphocyte PC-1 activity over control was found in hemodialysis patients. A two-month EPO therapy significantly decreased PC-1 activity to the control values, suggesting that an effect on PC-1 expression could be implicated in the amelioration of insulin resistance in uremic patients treated with EPO. Current investigations implicate that therapeutic modification of PC-1 expression would be of great benefit for insulin-resistant type 2 diabetics. Metformin, a biguanide oral antidiabetic agent, was shown to affect insulin resistance by decreasing enzymatic activity of overexpressed PC-1 molecules in obese type 2 diabetics. Thiazolidinedione (TZD) insulin-sensitizing drugs are a class of compounds that improve insulin action in vivo. Treatment of patients with TZDs seems to have a beneficial effect on most, if not all, components of metabolic syndrome. TZDs have also been used in the treatment of nondiabetic human insulin-resistant states, and have demonstrated an improvement in insulin sensitivity. Although much remains to be learned about PPAR gamma receptor and TZD action, the advent of TZD insulin-sensitizing agents has an enormous impact on our understanding of insulin resistance. The great potential of insulin resistance therapy illuminated by the TZDs will continue to catalyze research in this area directed toward the discovery of new insulin-sensitizing agents that work through other mechanisms.
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PMID:Plasma cell membrane glycoprotein 1 (PC-1): a marker of insulin resistance in obesity, uremia and diabetes mellitus. 1520 35

This report aims to compare the use of medication during pregnancy in Brazil according to socio-demographic variables in pregnant women who received prenatal care in Unified National Health System (SUS) facilities in six large cities. A structured questionnaire was applied to 5,564 pregnant women who attended prenatal care at SUS facilities, all of whom were participants in the Brazilian Study on Gestational Diabetes (1991-1995). The use of any type of medication presented a positive association with increases in schooling, age, and having a partner, and a negative association with an increase in the number of children. Multivitamin and digestive tract-related drug use showed a positive association with increased schooling and age and a negative association with increased number of children. The use of medication for anemia was negatively associated with increases in schooling and age. Use of multivitamins and GI drugs was associated with variables that characterize pregnant women with higher socioeconomic status, suggesting that medication during pregnancy is an expression of prenatal care.
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PMID:[Factors related to use of medication during pregnancy in six Brazilian cities]. 1560 62


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