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

Serial maternal serum alpha-fetoprotein (AFP) levels were determined by radioimmunoassay in patients with abnormal pregnancies and after saline-induced abortion. Results from patients presenting with mild or severe preeclampsia, fetal growth retardation and severe diabetes did not differ from the normal range. However, in patients with premature labor, the majority of AFP levels were significantly below the normal range, and peak AFP levels were achieved approximately one month earlier than normal. In patients whose pregnancies were terminated by abortion, the AFP levels exhibited a significant rise within a few hours after induction because of resorption of fetal elements into the maternal circulation.
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PMID:Maternal serum alpha-fetoprotein in abnormal pregnancies and during induced abortion. 7 May 33

Fetal pulmonary maturation may be a variable event depending on various feto-maternal environmental and biochemical influences. The patterns of maturation were studied in 211 amniotic fluid samples from 123 patients (normal 55; diabetes 23; Rh sensitization 19; preeclampsia 26). The phenomenon of globule formation from the amniotic fluid lipid extract and is relation to pulmonary maturity was utilized for this analysis. Validation of this technique is presented. A normal curve was constructed from 22 to 42 weeks; gestation and compared to the abnormal pregnancies. Patients with class A, B, and C diabetes and Rh-sensitized pregnancies had delayed pulmonary maturation. Patients with class D diabetes and preclampsia paralleled the normal course of maturation. A discussion of these results and their possible cause is presented.
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PMID:Patterns of pulmonary maturation in normal and abnormal pregnancy. 10 44

In normal pregnancy lecithin/sphingomyelin ratios correlate with gestational age. In complicated pregnancies biochemical maturation of fetal lung may be accelerated or delayed, depending upon maternal, fetal, or placental conditions. Surfactant contains other phospholipids besides lecithin, including phosphatidylglycerol (PG), the second major component of mature surfactant. Ninety phospholipid patterns in amniotic fluid were studied by two-dimensional thin-layer chromatography. In uncomplicated pregnancies PG was absent until 37 weeks' gestation, then increased there after. In complicated pregnancies (pre-eclampsia, diabetes Classes D, F, and R, premature rupture of membranes) PG was identified before 35 (as early as 29 weeks' gestation. These results verify accelerated lung maturation in certain complicated pregnancies. No newborn infant developed respiratory distress syndrome in the presence of PG.
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PMID:Significance of phosphatidylglycerol in amniotic fluid in complicated pregnancies. 10 3

Dehydroepiandrosterone sulphate (DHAS) was administered intravenously to 70 women in the third trimester of pregnancy. By measuring the increase in the concentrations of estrogens in maternal plasma, it was hoped to assess the reserve capacity of the placenta. In normal pregnancies, unconjugated estradiol invariably showed a marked increase within 60 minutes of the injection of DHAS, reaching 174 to 478% above basal levels. Changes in unconjugated estrone were more variable, but significant increases usually occurred 2 to 3 hours after the peak concentration of estradiol. The concentrations of unconjugated estriol showed no significant change. Patients with preeclampsia, essential hypertension, retarded intrauterine growth, diabetes, and twin pregnancies did not show any major differences in response compared to the normal pregnancies. Two patients with intrauterine deaths had low basal concentrations of estrogens but responded to the DHAS injection by having significantly increased concentrations of unconjugated estradiol after 60 minutes. The only patient who did not show any increase in unconjugated estradiol levels after DHAS was thought to have a placental sulphatase deficiency. This test does not appear to have any advantage over existing methods of assessing the endocrine function of the placenta except in confirmation of placental sulphatase deficiency.
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PMID:Plasma estrogen response to dehydroepiandrosterone sulphate injection in normal and complicated late pregnancy. 12 14

As estetrol (E4) is believed to be the steroid most likely to wholly dependent on fetal origin, we developed a radiommunoassay for unconjugated and conjugated E4 (E4-U and E4-G) and investigated plasma and urinary levels serially throughout the second half of pregnancy to establish their validity by means of monitoring or screening tests to assess fetal well-being. E4 exhibits a remarkable increase during the latter half of pregnancy. At term, the mean E4-U level in maternal peripheral plasma was 0.67 +/- 0.33 ng/ml, a five fold increase from that at 28 weeks; E4-G was 4.57 +/- 2.84 ng/ml, showing a four fold increase; and E4-G levels in maternal urine were 1.68 +/- 0.96 mg/day, showing a three fold increase from that at 28 weeks. E4-U and E4-G levels showed no diurnal change. The coefficient of the correlation between plasma E4-U and E4-G was 0.699, which is satisfactory, but no correlation was found between urinary and plasma E4 levels. A significant correlation was shown between maternal and umbilical E4-U (r=0.820) and E4-G (r=0.608). No relationships between E4 levels and birth weight were detected. Pre-eclampsia, Rh-isoimmunization and diabetes mellitus are common complications of pregnancy which may cause latent fetal distress. Prenatal fetal assessment was performed by serial daily evaluations of these E4 values. In pre-eclampsia resulting in a small full term baby, E4 levels were mostly below normal mean values or failed to show an increased pattern. In addition, the E4 levels decreased in one case of neonatal death. In Rh-isoimmunization, plasma E4-G levels were lower in the group affected severely by the hemolytic desease. In a patient with diabetes mellitus delivered of a healthy baby, E4 levels were within the range of a normal pregnancy. In order to evaluate fetal and placental reserve capacities as well as feto-placental function, the dehydroepiandrosterone sulfate (DHA-S) loading test was performed by loading selected subjects with 50 mg of DHA-S, then serially measuring the E4 in the maternal plasma and urine. Intravenous infusion of 50 mg of DHA-S was completed in 60 minutes. A rapid and sharp increase of plasma E4 was observed, reaching maximal concentrations at 120 minutes in normal pregnancies. However, urinary levels showed patterns similar to those reported for estriol (E3). In some abnormal pregnancies, no increased or delayed patterns were observed in plasma E4-G levels, while the serial levels remained within the normal range. This possibly suggests that in these pregnancies, fetal functions had been inhibited or had reached their limit. It is concluded that the simultaneous determinations of serial E4 levels accompanied by the DHA-S loading test may be of value in assessing fetal well-being and reserve capacity and may therefore improve fetal and neonatal prognosis in abnormal pregnancies.
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PMID:[The determination of plasma and urinary estetrol (E4) for assessing fetal and neonatal prognosis (author's transl)]. 14 80

Simultaneous determinations of unconjugated estriol and 15alpha-hydroxyestriol (E4) levels in maternal serum were studied serially to ascertain the relative usefulness of these estrogens as indicators of fetal welfare. Complicated pregnancies included 16 patients with pre-eclampsia and/or hypertension, six patients with severe Rh-isoimmunization, 12 patients with diabetes mellitus, of which four had vascular disease, three patients with fetal death in utero, and three twin pregnancies. Retrospective analysis failed to indicate a clinically useful role for serum E4 determinations in the evaluation of fetal welfare during high-risk pregnancies.
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PMID:Unconjugated estriol and 15alpha-hydroxyestriol in complicated pregnancies. 40 91

The estriol 16-glucuronid excretion was determined in 186 urine samples in cases with preeclampsia, post maturity, pregnancies past the expected date of confinement, intra-uterine fetal deaths, congenital anomalies, Rhesus incompatability and diabetes mellitus. In groups with mild dystrophy, severe dystrophy, and intra-uterine fetal death, three zones of estriol 16-glucuronid excretion were determined. Zone 1 is suggestive of a possible fetal impairment. Zone 2 shows a high probability of fetal impairment and Zone 3 was considered as lethal zone suggestive of imminent intra-uterine fetal death. The degree of rhesus incompatability, disease of the fetus or of diabetogenic fetopathy was not recognizable by the estriol 16-glucuronid excretion.
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PMID:[The follow-up of high risk pregnancies with the determination of estriol 16-glucuronid excretion. Second: Excretion in preeclampsia, post maturity, intrauterine growth retardation, diabetes, Rh incompatability and intrauterine fetal deaths (author's transl)]. 40 21

Bacteriolytic activity and lecithin concentration were measured in amniotic fluid samples from both normal and pathologic pregnancies, including conditions such as severe Rh isoimmunization, placental dysfunction, preeclampsia, and diabetes. The bacteriolytic activity increased threefold from the 25th gestational week to term, after which a slight reduction was found. No difference was found between pathologic and normal pregnancies. No correlation was found between lecithin content and bacteriolytic activity. Samples from pregnancies in which the infant developed respiratory distress syndrome had low lecithin concentrations but showed normal bacteriolytic activities.
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PMID:Bacteriolytic activity of amniotic fluid. 41 73

Plasma levels of non-conjugated oestrone were measured with a radio-immunological method in women with complicated pregnancies during the last trimester. A comparison was performed between values of normal pregnancies from a previous report (3) and those of pathological pregnancies. Women with severe pre-eclampsia were found to have low values and to some extent the oestrone level could predict fetal outcome. In pregnant patients with long-standing diabetes mellitus the plasma levels of oestrone seemed to be higher than those of uncomplicated pregnancy. In women with pregnancies complicated by Rh-isoimmunization, oestrone plasma levels were similar to those found in normal pregnancies.
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PMID:Plasma levels of non-conjugated oestrone in high risk pregnancies. 41 46

The most important side effects of oral contraceptives (OCs) and their incidence, together with advice and monitoring of the patient at risk, are pointed out. There is a mild increase in blood pressure in longterm contraceptive use caused by increased angiotensinogen production by the liver. It is significant only for women with a history of familial hypertension, diabetes mellitus, or pre-eclampsia. Smoking increases this risk. Urinary tract infections are 25-50% more frequent in pill users. Glucose tolerance is slightly decreased. Contraceptives' diabetogenic effect is higher in women with hereditary tendency for diabetes, latent diabetes, and/or obesity. They are contraindicated in latent diabetes. Findings are contradictory in their effects on cholesterol and triglyceride serum level, but the pill is contraindicated in lipid metabolism disorders. There is an increased incidence in cholecystitis and cholelithiasis in pill-users (70-80 additional cases/100,000 user years). Liver diseases, intrahepatic cholestasis, occur rarely and benign liver tumors have not conclusively been proved to be caused by the pill. A variety of laboratory findings have been related to contraceptive use and drug interactions occur with barbiturates, rifampicin, hydantoin, and phenylbutazone. Blood coagulation is increased, partially by increased production of various blood coagulation factors; but more importantly, by a decreased synthesis of antithrombin III, a natural protective mechanism against intravascular coagulation. This increases thrombosis risk. Risk doubles with simultaneous cigarette smoking. Various epidemiological studies indicate a 5-10 fold increase in thromboembolism and thrombophlebitis, deep vein thrombosis, and pulmonary embolism. There is a correlation between contraceptive use and cerebrovascular disorders and myocardial infarction. This risk increases with age and years of pill use. The pill is contraindicated with symptoms of thrombophlebitis and thromboembolism, sickle cell anemia, proposed surgery, and longterm immobilization. Overall risk factors are not too high. Recommendations for rational pill use related to age are given and further contraindications are mentioned.
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PMID:[Adverse effects of oral contraceptives]. 55 52


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