Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The contraction stress test (CST) has become widely used to assess antepartum fetal well-being over the past 5 years. A summary of 14 reports in the literature revealed seven fetal deaths in 1739 patients within 1 week of a negative CST, an incidence of 0.4%. This prompted an investigation of our results for comparison. During the period January 1, 1975, to February 28, 1977, 746 patients underwent 1119 CSTs. Seven fetal deaths occurred in 680 patients within 1 week of a negative CST, an incidence of 1.0%. Although maternal conditions associated with fetal demise within 1 week of a negative CST include diabetes mellitus, prolonged pregnancy, chronic hypertension, and pre-eclampsia, fetal death in most instances resulted from factors other than uteroplacental insufficiency (UPI). Conditions commonly associated with fetal demise following a negative CST were umbilical cord accidents, severe congenital anomalies, and abruptio placentae. The low incidence of fetal death after a negative CST supports continued use of the CST in evaluation of high-risk pregnancies.
 ...
PMID:Fetal demise following negative contraction stress tests. 66 43

In a retrospective review of 440 pregnancies occurring in women over the age of 40, increased frequencies of both perinatal and maternal complications were noted. The perinatal mortality rate of the study group was three times greater than that of the general obstetric population. There were increased incidences of both low and high birthweight infants. Neonatal morbidity was increased. Congenital abnormalities were noted in 12 infants, including 2 infants with cytogenetic abnormalities. Hypertensive disorders complicated one-third of the pregnancies. Diabetes mellitus and abruptio placentae occurred with increased frequency. Cesarean section was required in 12.2% of the deliveries.
 ...
PMID:Pregnancy in women over forty. 84 Apr 53

Among 58,187 women tested, 1002 had a maternal serum alpha-fetoprotein measuring greater than or equal to 2.5 multiples of the median after correction for race, weight, and insulin-dependent diabetes. They were stratified into three groups: group 1, 2.5 to 2.9; group 2, 3.0 to 5.0; group 3, greater than or equal to 5.0 multiples of the median. The initial risk of a serious abnormality detected by ultrasonography or amniocentesis was 17% (5%, 12% and 65% in groups 1, 2, and 3, respectively). After correction for twins and dates, this risk became 23% (7%, 18%, and 71% in groups, 1, 2, and 3, respectively). Among the women with high maternal serum alpha-fetoprotein levels, 556 (77%) had normal ultrasonographic and amniocentesis studies, and the risk of adverse pregnancy outcome ws 27% (19%, 29%, and 70% in groups 1, 2, and 3, respectively). There was a statistically significant increase in late fetal and perinatal death, prematurity and growth retardation, oligohydramnios, abruptio placentae, preeclampsia, and congenital abnormalities. The overall risk for abnormality or adverse outcome was 24% in group 1, 41% in group 2, and 91% in group 3.
 ...
PMID:Risks associated with an elevated maternal serum alpha-fetoprotein level. 171 19

The aim of this study was to assess any changes in cause-specific fetal death rates in the nonreferred population of a tertiary care unit. The fetal death rate (per 1000 births) among 88,651 births diminished from 11.5 in the 1960s to 5.1 in the 1980s. Fetal death due to intrapartum asphyxia and Rh isoimmunization has almost disappeared. Toxemia and diabetes continue to make similar and small contributions to fetal death rates. There has been a significant decline in unexplained antepartum fetal deaths and in those caused by fetal growth retardation, but no significant change in the death rate due to intrauterine infection or abruptio placentae. During the 1960s, the risk of fetal death was increased in women with hypertension, diabetes, or a history of stillbirth; during the 1980s, only women with a history of insulin-dependent diabetes were at risk. Improved application of current knowledge may help decrease the fetal death rate caused by fetal growth retardation. Reduction in deaths due to abruptio placentae, intrauterine infections, or lethal malformations, as well as unexplained antepartum deaths, appears to depend on better understanding of the etiology of these disorders.
 ...
PMID:The changing pattern of fetal death, 1961-1988. 172 82

Infertility, spontaneous abortions and trisomic anomalies increase with maternal age, as do ectopic pregnancy, low birth weight, macrosomia, abruptio placentae and labor dysfunction. However, those phenomena are multifactorial in origin and cannot be ascribed solely to advancing age. Older pregnant women are also at increased risk for diabetes and hypertension. Whereas the older gravida is at increased risk for maternal mortality and morbidity and for fetal and infant mortality, those problems are explainable in large part by coexisting medical complications. The healthy older pregnant woman who receives appropriate prepregnancy counseling and up-to-date perinatal care can achieve results comparable to those achieved by younger ones.
 ...
PMID:Reproduction in the older gravida. A literature review. 181 94

An analysis of 10,159 normal spontaneous vaginal deliveries was performed to examine racial differences in mean birth weight of infants whose mothers were without antepartum or intrapartum medical complications of pregnancy. The study was limited to black and white infants of low-income mothers who were inborn, singleton, and weighed greater than or equal to 500 gm at birth. High-risk maternal transfer patients and patients with hypertension, toxemia, bacteriuria, pyelonephritis, renal failure, diabetes, anemia, polyhydramnios, oligohydramnios, prolapsed cord, vaginal bleeding, placenta previa, abruptio placentae, prolonged rupture of membranes, maternal fever on admission, amnionitis, sexually transmitted diseases, or fewer than five prenatal care visits were excluded. When statistically significant differences in demographic characteristics were controlled, black infants had an average birth weight 181 gm less than that of white infants.
 ...
PMID:Birth weights of infants of black and white mothers without pregnancy complications. 203 72

In Bahrain, the Ministry of Health (MOH) medical facilities, which included 1 main maternity hospital, 2 peripheral hospitals, and 3 maternity units under the direction of midwives, reported 29,644 births during January 1985-December 1987. 355 of these were stillbirth and 228 infants died within the 1st week which made up a perinatal mortality rate of 19.6/1000 births. The leading causes of perinatal deaths included, in descending order, low birth weight, mainly due to prematurity (29.3%); congenital malformations (24.9%); mechanical problems, especially cord complications (12%), antepartum hemorrhage, most caused by abruptio placentae (9.1%), and preeclampsia (9.1%). Of the 438 normally formed infants that died, 185 (42.2%) of these were antepartum, 115 (26.3%) intrapartum, and 138 (31.5%) postpartum. 45 (10%) of the normally formed infants that died weighed above the 10th percentile for their gestational age and there were no maternal complications. The researchers classified 101 of all the infant deaths (17.3%) as avoidable perinatal deaths--70% due to poor patient compliance, 28% due to medical mismanagement, and 2% due to a combination of these factors. The MOH must emphasize health education and regular prenatal visits for pregnant mothers. Health practitioners need to reevaluate present prenatal and intrapartum clinical methods and to routinely screen for diabetes and other possible high risk factors.
 ...
PMID:Perinatal mortality in Bahrain. 325 Apr 47

During 1978-1983, 57 maternal deaths (23 in blacks, 32 in coloureds and 2 in whites) occurred among 131,288 deliveries (36,564 in blacks, 89,335 in coloureds and 5389 in whites) in the Peninsula Maternal and Neonatal Service, Cape Town. Data for whites were not analysed further. Maternal mortality rates (MMRs) were higher in blacks than in coloureds. Age- and parity-specific MMRs showed that black teenagers and primiparas and coloureds aged 20-34 years and of parity 2-4 had the lowest rates. Advanced age and grand multiparity had a much greater adverse effect in coloureds than in blacks. Eighteen per cent of deaths in blacks and 9% of those in coloureds were in unbooked patients. The main causes of death (obstetric and non-obstetric) in blacks were sepsis, abruptio placentae, eclampsia and pneumonia. In coloureds they were eclampsia, other manifestations of proteinuric hypertension, cardiac disease, sepsis, haemorrhage (grouped) and diabetes. Of those who died, 43% of blacks and 38% of coloureds had had a caesarean section. The perinatal mortality rate was 417 for blacks and 469 for coloureds. A number of avoidable factors were identified. Most, if not all, deaths occurred because simple perinatal rules were broken.
 ...
PMID:Maternal mortality in Cape Town, 1978-1983. 371 61

Stressed and non-stressed antenatal fetal monitoring was carried out 9 520 times in 5 932 high-risk patients. Intra-uterine death occurred in 48 patients. In 19 patients the fetus died within 1 week of monitoring but before the onset of labour; the results of monitoring had been normal in 14 of these. Abruptio placentae was the cause of 6 of these deaths. Many of the other causes of intra-uterine death were also acute complications such as haemorrhage due to placenta praevia, amniotic fluid infection, and cord prolapse. True false-negative test results were rare, and were seen most often in patients with preeclampsia, diabetes and haemolytic disease. Twin pregnancies also caused a problem, as double recording of the heart rate of the normal fetus could create a false sense of security.
 ...
PMID:Intra-uterine deaths after suspicious, uncertain and normal antenatal fetal heart rate monitoring. 740 46

Grandmultiparity (GMP) has long been considered an obstetric complication for both mother and fetus, although recent studies indicate that, with proper perinatal care, women with high-parity rates are no longer at high risk. The current study examines the outcome of delivery in 1700 women in their fifth or more delivery, as compared with two control groups: 622 primiparas and 735 multiparas (two to three previous deliveries). Excellent prenatal care was available free of charge to all parturients. Our objectives were to evaluate the management of GMP in contemporary obstetrics and to assess whether grand multiparas are still high-risk patients. The age of the grandmultiparas was significantly higher compared with with the control groups, which may explain the higher incidence among them of antenatal medical disorders, such as diabetes mellitus and hypertensive disease. No significant differences were found among the three groups for preterm or post-term births, small-for-gestational-age infants, polyhydramnios, oligohydramnios, perinatal death, fetal distress, multiple births, placenta previa, abruptio placentae or cord prolapse. Macrosomia was markedly higher in the grandmultiparas and multiparas than in nulliparas. Thus, our results indicate that good perinatal care can ensure better results in grandmultiparas, and that grandmultiparity no longer needs to be considered a high-risk obstetric category in our population.
 ...
PMID:The grand multipara. 755 29


1 2 3 Next >>