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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of this report is to compare subsequent pregnancy outcome and incidence of chronic hypertension and diabetes on follow-up in two groups of patients. Group 1 included 406 young women who had severe preeclampsia-eclampsia in their first pregnancies. Group 2 consisted of 409 young, well-matched women who remained normotensive during their first pregnancies. All patients were followed up for a minimum of 2 years (range 2 to 24). The preeclamptic-eclamptic group had a higher incidence of preeclampsia in their second pregnancies (46.8% versus 7.6%, p less than 0.0001) and in subsequent pregnancies (20.7% versus 7.7%, p less than 0.001) when compared with the normotensive group. The overall incidence of chronic hypertension was significantly higher in the preeclamptic-eclamptic group (14.8% versus 5.6%, p less than 0.001). Most of the difference occurred in patients followed up greater than or equal to 10 years. Within the preeclamptic-eclamptic group, patients having preeclampsia-eclampsia at less than or equal to 30 weeks' gestation and those having recurrent preeclampsia in their second pregnancies had a significantly higher incidence of subsequent chronic hypertension (p less than 0.001) than was found in the other patients. Within the normotensive group, patients remaining normotensive in subsequent pregnancies had the lowest incidence of chronic hypertension.
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PMID:Severe preeclampsia-eclampsia in young primigravid women: subsequent pregnancy outcome and remote prognosis. 377 42

Acetylcholine (ACh) is localized in the syncytiotrophoblast layer of the human placental villous tissue. An attempt was made to correlate the ACh synthesis in different pathological placentas with the histopathology of the syncytiotrophoblast available in the literature. The ACh synthesis was estimated by 'in vitro' incubation of the placental tissue. Full-term (36-38 weeks) vaginally delivered pathological placentas and hydatid moles (28 weeks) were compared with normal placentas of the same age. The results suggested that: ACh synthesis is normal in states with normal syncytiotrophoblast (e.g., healthy greater than 42 week placenta, placenta praevia, twins, and hydramnios); high ACh synthesis is correlated with hormonal and immunological changes (e.g., diabetes mellitus and Rh-incompatibility); low levels of ACh synthesis occur in states with moderate syncytial degeneration (e.g., nephrotic syndrome and essential hypertension); very poor ACh synthesis occurs when syncytial degeneration is advanced (e.g., preeclampsia, eclampsia, intra-uterine death of fetus, vesicles of hydatid mole and placental tissue infarcts); and ACh synthesis is nil in material that is completely devoid of syncytiotrophoblast (e.g., placental tissue-like material, which rarely appears in between the vesicles of hydatid moles). In essence, the degree of reduction in ACh synthesis seems to correlate with the state of the syncytiotrophoblast in various pathological conditions; and ACh synthesis is greatly reduced during syncytial degeneration. It is concluded that the capacity of the placenta to synthesize ACh reflects the state of the syncytiotrophoblast.
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PMID:A correlative review of acetylcholine synthesis in relation to histopathology of the human syncytiotrophoblast. 379 52

A follow-up study was conducted with 50 healthy parous volunteer women in India to ascertain the effect of a long-acting progestogen contraceptive on serum enzymes and hepatic function. The women received an intramuscular injection of a long-acting contraceptive, DMPA (depo-medroxyprogesterone acetate), in a dose of 150 mg every 3 months for 2 years. Women with a past history of jaundice, diabetes, hypertension, or eclampsia were excluded from the study. The activity of SGOT, SGPT, and AP (alkaline phosphatase) did not show any change during the longterm treatment. This result would indicate normal hepatic function and the absence of any damage or injury to the liver cells. Activity of serum ACP (acid phosphatase) and AChE (acetylcholinesterase) in red cells did show significant increase, which continued up to the end of the study. Results of the study indicate that DMPA is a suitable contraceptive for use in India, particularly since it does not cause the common side effects associated with oral contraceptives and does not affect liver function.
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PMID:Effect of medroxyprogesterone acetate contraception on human serum enzymes. 611 6

94 maternal deaths and 1546 fetal and neonatal deaths were registered among 28,706 births at the CHU Averroes in Casablanca between 1978-80. 45% of women who deliver at the clinic are very poor and only 10% are relatively well off. Obstetrical antecedents were noted in 27% of the fetal deaths. 70% of the maternal deaths occurred in women aged 20-34. 32 maternal deaths occurred among 16,232 women with 1-2 children, 30 among 6514 women with 3-5 children, and 32 among 5960 women with 6-14 children. 11,027 of the 28,706 were primaparas. Perinatal mortality was 4.46% among primaparas, 8.24% among grand multiparas, and 4.1% among secondiparas. In 58 of the 94 cases of maternal mortality the woman was hospitalized after attempting delivery at home or in a village clinic. Among women with 1 or 2 children, hemorrhage was the cause of death in 8 cases, infection in 7 cases, eclampsia in 3 cases, thromboembolism in 2 cases, uterine inversion in 2 cases, pulmonary tuberculosis in 1 case, embolism in 5 cases, and other causes 1 case each. Among women with 3-5 children hemorrhage was the cause of death in 10 cases, septicemia in 3 cases, uterine rupture in 3 cases, eclampsia in 3 cases, uterine inversion in 2 cases, viral hepatitis in 2 cases, emboli in 2 cases, and other reasons 1 case each. Among grand multiparas hemorrhage was the cause of death in 11 cases, uterine rupture in 12 cases, peritonitis in 2 cases, eclampsia in 2 cases, emboli in 2 cases, and other causes 1 case each. 19 of the maternal deaths were judged to have been avoidable with better management. Prematurity and birth weight of 1000-2500 g associated or not with other pathology were found in 714 of 1546 perinatal deaths. Of 390 cases of death in utero with retention and maceration, 68 were caused by reno-vascular syndromes, 76 by maternal infections, 33 by maternal syphilis, 26 by fetal malformation, 18 by maternal diabetes, 10 by Rh incompatability, and 159 by indeterminate causes. In 795 cases of intrapartum mortality without maceration, 114 were caused by retroplacental hematomas, 61 by placenta previa, 74 by uterine rupture, 119 by prolapse of the cord, 51 by fetal malformation, 45 by dystochia, 53 by twin pregnancies, 104 by fetal distress, 44 by obstetrical trauma, 55 by prematurity, and 75 by undetermined causes. In 361 cases of early neonatal mortality, 88 were caused by renovascular syndromes, 24 by diabetes, 13 by Rh incompatibility, 34 by placenta previa, 94 by prematurity, 28 by fetal malformation, 35 by fetal infections, 31 by fetal distress, and 14 by obstetrical trauma. The rates of maternal and perinatal mortality are very high compared to those of European countries.
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PMID:[Maternal mortality and perinatal mortality]. 720 85

In-vitro experiments are presented which indicate that the concentration of extracellular magnesium ions ([Mg2+]o) can exert profound influences on the contractility and reactivity of arteries, arterioles and veins from a number of regional vasculatures in several mammalian species, including man. Hypomagnesemia can potentiate the contractile activity of a variety of neurohumoral substances and induce vasospasm. Hypermagnesemia can do the reverse, i.e., induce hyporeactivity, relaxation and vasodilatation. Data are also presented to indicate that [Mg2+]o can control the entry, distribution and exit of calcium ions (Ca2+) from vascular smooth muscle cells. Arterial and venous smooth muscles excised from rats with alloxan-diabetes mellitus or spontaneous hypertension (SHR) appear to exhibit vascular membranes which have modifications in their Mg-Ca exchange sites. Data are reviewed which suggest that certain vascular diseases (e.g., sudden-death ischemic heart disease, hypertension, eclampsia, diabetes mellitus) are associated with a Mg-deficiency. Overall, it is suggested that [Mg2+]o and membrane [Mg] may play critical roles in regulating vascular tone and homeostasis.
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PMID:Hypomagnesemia and vasoconstriction: possible relationship to etiology of sudden death ischemic heart disease and hypertensive vascular diseases. 730 71

A case-control study was conducted to investigate risk factors for eclampsia. A total of 66 cases of eclampsia were ascertained from deliveries between 1977 and 1992 at two hospitals in Houston, Texas, based on the criteria defined by the American College of Obstetrics and Gynecology. Cases were matched to nonpreeclamptic controls on a 4:1 ratio on the basis of hospital and month of delivery. The ratio of eclampsia cases to number of deliveries over the study period was 0.63 per 1,000. In a logistic regression model, risk factors for eclampsia included 1) two or fewer prenatal care visits (odds ratio (OR) = 6.10, 95% confidence interval (CI) 2.26-16.41), 2) urinary tract infection (OR = 4.23, 95% CI 1.27-14.06), 3) primigravidity (OR = 2.87, 95% CI 0.97-8.44), 4) obesity (OR = 2.49, 95% CI 0.78-7.96), 5) black ethnicity (OR = 2.25, 95% CI 0.88-5.78), 6) history of diabetes (OR = 2.07, 95% CI 0.45-9.62), and 7) age < or = 20 years (OR = 1.55, 95% CI 0.47-5.10). Nulliparity was not shown to be a risk factor for eclampsia when controlled for primigravidity, and neither were previous history of abortion or previous history of pregnancy-induced hypertension. Thus, prior pregnancy itself, independent of outcome and preeclamptic/eclamptic complications, appears to be the protective factor against eclampsia in a subsequent pregnancy.
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PMID:Case-control study of the risk factors for eclampsia. 762 9

This study was conducted to determine the incidence of low birth weight (LBW) in the indigenous population of Al Ain and to identify some risk factors associated with it. The population studied included all consecutive deliveries, occurring in the 3 hospitals in Al Ain City, where almost all deliveries take place, during a 1-year period. When a LBW infant (< 2,500 g) was born, gestational age assessment was made and a questionnaire completed during an interview with the mother. For control, the first baby who weighed more than 2,500 g at birth, following the birth of a LBW was recruited. It was found that a total of 3,485 live births occurred of which 293 were classified as LBW, giving an LBW incidence of 8.4%. Of these, 73 (24.9%) were small for gestational age (< 10th percentile for gestational age). Overall, the mothers of LBW infants were found to be statistically significantly younger in age. The mothers of LBW infants also had a significantly higher number of previous LBW deliveries, twin deliveries and a larger number of premature rupture of membranes. The factors that were not significantly different in the 2 groups were diabetes during pregnancy, chronic hypertension, preeclampsia/eclampsia, occurrence of significant infection during pregnancy, 1st and 2nd trimester bleeding, and antepartum hemorrhage. This is the first comprehensive study on the incidence of LBW infants in the United Arab Emirates. The main obstetric factors responsible for this were found to be age, number of previous LBW babies, premature rupture of membranes and multiple births.
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PMID:Obstetric risk factors affecting incidence of low birth weight in live-born infants. 764 Mar 14

HELLP syndrome (haemolysis, elevated liver function tests and low platelets) is a multiorganic disease and has been described in combination with pre-eclampsia/eclampsia, but even without symptoms of gestosis. There are signs, that HELLP syndrome represents an "acute status of autoimmunity". Since immune mechanisms play a fundamental role together with other factors in the development of type I diabetes mellitus, a combination of autoimmune reactions could explain the development of type I diabetes during an altered immune status. We report on the course of a pregnancy complicated by HELLP syndrome, which developed type I diabetes mellitus in the same pregnancy. A subsequent pregnancy with adequate diabetes therapy was uncomplicated and without recurrence of HELLP syndrome.
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PMID:[HELLP syndrome and manifestation of type I diabetes mellitus in pregnancy]. 785 13

Based on centrally recorded data about all pregnancies that led to delivery in Sweden in the years from 1973 to 1981 this longitudinal study considers the course of pregnancies of all women who gave birth to their first three single babies during observation time especially regarding hypertension, proteinuria, pre-eclampsia and eclampsia-here subsumized under HP-disease. Incidence of HP-disease is shown to be 8.1% of all observed women, depending on the theoretical approach at a minimum of 34% and a maximum of 44% being due to primary, pregnancy-induced HP-disease. Some epidemiologic findings may give some hints on the etiology of HP-disease: In primary HP-disease mother's age is in the normal range, whereas infection of the urinary tract, diabetes mellitus, fetal deformity are found more frequently. Female fetus are over-represented with existence of HP-disease. The influence of HP-disease presence and parity on fetal development and fetal outcome are discussed.
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PMID:[Epidemiological indications for the etiology of proteinuria, hypertension in pregnancy and pre-eclampsia--a longitudinal cohort studies of all Swedish women giving birth between 1973 and 1981 to 3 singleton infants]. 787 55

In an attempt to identify causes of perinatal mortality and thence devise preventative strategies on the island of Jamaica, a study was made of the 1847 singleton perinatal deaths occurring over the 12-month period between 1 September 1986 and 31 August 1987. Complications of the pregnancy were elicited by questioning the mother as well abstracting data from the antenatal and clinical obstetric records. The deaths were classified using the Wigglesworth categorisation and the three largest groups were chosen for special study: antepartum fetal deaths, deaths of live birth from immaturity and deaths from intrapartum asphyxia. The medical features of the pregnancies were compared with data similarly obtained from 9919 women delivering singletons in the 2 months of September and October 1986 and who survived the first week of life. Unadjusted statistically significant associations were found with maternal syphilis, vaginal infection or discharge, bleeding in the first two trimesters, bleeding in the third trimester, lowest haemoglobin, highest diastolic and first diastolic blood pressures, highest level of proteinuria, diabetes and antenatal eclampsia. Logistic regression taking account of social, environmental and health behaviour variables showed the following significant relationships. Antepartum fetal death was associated with adjusted odds ratio (AOR) for syphilis 2.88 [95% confidence interval (CI): 1.91, 4.32], bleeding in third trimester 3.86 [2.73, 5.44], highest diastolic blood pressure (P < 0.0001), highest level of proteinuria (P < 0.0001), lowest Hb (P < 0.0001) and antenatal eclamptic fits AOR 4.62 [1.47, 14.50]. Deaths from immaturity were independently associated with bleeding < 28 weeks AOR 3.50 [2.39, 5.13], bleeding 28 + weeks AOR 1.93 [1.16, 3.22], highest diastolic blood pressure (P < 0.01) and highest level of proteinuria (P < 0.0001). Infection featured in deaths associated with intrapartum asphyxia, with syphilis AOR 2.17 [1.44, 3.26] and vaginal infection/discharge (P < 0.01) independently associated; other strong associations were bleeding < 28 weeks AOR 2.10 [1.57, 2.81], bleeding 28 + weeks AOR 2.32 [1.62, 3.33], highest diastolic blood pressure (P < 0.0001), first diastolic blood pressure (P < 0.0001) and antenatal eclampsia AOR 6.70 [2.63, 17.13]. For all perinatal deaths combined, independent features were syphilis AOR 2.06 [1.49, 2.85], vaginal infection/discharge (P < 0.001), bleeding < 28 weeks AOR 2.01 [1.60, 2.53], bleeding 28 + weeks AOR 2.65 [2.02, 3.48], highest diastolic blood pressure (P < 0.0001), first diastolic blood pressure (P < 0.0001), proteinuria (P < 0.0001) and antenatal eclampsia AOR 4.22 [1.76, 10.14]. The results help identify areas for monitoring and identifying pregnancies at highest risk.
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PMID:Medical conditions present during pregnancy and risk of perinatal death in Jamaica. 807 3


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