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

Intravenous glucose tolerance tests were performed on 30 primigravidae with pre-eclampsia and 15 normal primigravidae in late pregnancy. The groups were matched for age, height and weight and had no stigmata of potential diabetes. Plasma glucose, plasma immunoreactive insulin and plasma placental lactogen (HPL) levels were measured before (fasting) and at timed intervals after the glucose challenge; the glucose response was expressed as the increment index. The patients with severe pre-eclampsia had significantly lower fasting plasma glucose levels than those with mild pre-eclampsia and normal pregnancies. The mean increment index in both the severe and mild pre-eclamptic groups was significantly lower than that of the normal pregnant group. Fasting HPL levels were significantly lower in patients with severe pre-eclampsia than in those who had mild pre-eclampsia or a normal pregnancy. Both the fasting plasma insulin and insulin response following glucose injection were lower in patients with severe pre-eclampsia than in those with mild pre-eclampsia or a normal pregnancy. The differences however were not statistically significant. The results of this study suggest that carbohydrate metabolism in severe pre-eclampsia is altered to an extent similar to that in patients with chemical gestational diabetes, and this alteration may be due to maternal beta-cell anoxia caused by the vascular changes in pre-eclampsia.
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PMID:Carbohydrate metabolism in pre-eclampsia. 103 12

A retrospective study of 84 women under age 45 years suffering myocardial infarction. These patients were found in the records of 24 hospitals is presented. 16 died in the hospital; 5 died subsequently; of the remaining 50 showed definite evidence and 13 possible evidence of myocardial infarction. Suitable controls were selected from patients with other disorders. Patients were interviewed in their homes, some additional information was supplied by the medical practitioner; and fasting blood samples were obtained from some at more than 6 months after the infarction. The proportion of patients who had used oral contraceptives during the month before admission was significantly higher among infarction patients than among controls (p less than .001). The relative risk was estimated as 4.5 to 1. The proportion of those who had ever used oral contraceptives was higher (p less than .01). Cigarette smoking was reported more often by patients with infarction than by controls. A higher ratio of patients with infarction than controls had been treated for hypertension, diabetes, preeclampsia, and obesity. Blood lipids were examined in 44 patients and 84 controls. Mean levels of serum cholesterol and serum triglycerides were definitely higher in patients who had had infarctions. The estimated yearly hospital admission rate for nonfatal myocardial infraction is 2.1 per 100,000 married women aged 30-39 years who do not use oral contraceptives and 5.6 per 100,000 for married women of this age who do. In the 40-44 year age group the rates are 9.9 and 56.9 per 100,000 respectively. Risk estimates suggest that the combined effects of factors is synergistic. When other risk factors exist, different methods of contraception are advised.
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PMID:Myocardial infarction in young women with special reference to oral contraceptive practice. 116 93

Seven hundred sixty-seven oxytocin challenge tests (OCT) were performed on 333 high-risk maternity patients. All of the patients had pregnancies complicated by diabetes mellitus, suspected postmaturity, preeclampsia, intrauterine growth retardation, hypertension and other disorders. In conjunction with OCT, 24-hour urinary estriol determinations were performed. Negative OCT's were reassuring for fetal well-being. There were 26 positive OCT's on 24 patients. A positive test was significant in identifying endangered fetuses existing in a markedly unfavorable environment. In our experience, we found the OCT more reliable and more predictable than urinary estriol determination. The oxytocin challenge test proved to be significant in the successful management of these 333 high-risk patients.
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PMID:Oxytocin challenge test in high-risk pregnancy. 125 May 37

Maternal tissue oxygenation was reflected by the level of red cell, 2,3-diphosphoglycerate (DPG) was measured before, during and after normal pregnancy. Following an initial fall at the beginning of pregnancy there was a significant rise in the mean level of DPG during pregnancy with an abrupt fall in the puerperium. The mean red cell DPG level in the third trimester of pregnancies complicated by pre-eclampsia and diabetes was not statistically different from the normal but the mean value of all pregnancies in which the fetus was stillborn or growth retarded was significantly lower (p less than 0-001). The possible mechanism of the changes in normal and abnormal pregnancy is discussed and it is suggested that the measurement of red cell DPG in the third trimester of pregnancy may prove to be a useful parameter of placental oxygenation.
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PMID:Tissue oxygenation and red cell 2,3-diphsophoglycerate in normal and abnormal pregnancy. 126 47

To evaluate recent management of pregnancy in women with sickle cell hemoglobinopathy, pregnancy outcomes of 29 women with homozygous (HbSS) disease, 52 with double heterozygous (HbSC) disease, and 51 normal (HbAA) women were assembled. The case series was 132 singleton births to 132 Ghanaian women, 81 of whom were from the Korle-bu Teaching Hospital, Accra, from June 1988 to October 1991. Controls had no history of hypertension, diabetes, rhesus isoimmunization, or pre-eclampsia, and their infants with significantly lower birth weight (mean 2.59 kg), at lower gestational age (35.2 weeks) than controls. Doubly heterozygous sickle cell mothers had infants with a shorter gestational age (36.4 weeks) than controls (37.25 weeks), yet averaging the same birthweight as controls (3.10 kg). The placental weights were not significantly different between the 3 groups. The results were interpreted to suggest that children of HbSC mothers were large for gestational age (LGA). Continuous sickling of the mother's red blood cells is thought to be the cause of poor outcomes in homozygous sickle cell pregnancy.
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PMID:Comparative studies of live neonates in maternal sickle cell haemoglobinopathy in Ghana. 129 39

A retrospective study of 1989 records of 10,594 pregnant women registered at 47 primary health care (PHC) centers in Al-Hassa, Saudi Arabia, aimed to evaluate the performance of their prenatal care services and to gather baseline data to conduct future evaluations. These women represented 58% of pregnant women in Al-Hassa in 1989. The other pregnant women may have received prenatal care at medical facilities of the Arabian American Oil Company (ARAMCO), the National Guard, or the private sector. 53.1% of the registered women had made more than 5 prenatal care visits. 66.7% and 40.3% of all registered women received the first and second dose of tetanus toxoid, respectively. PHC center staff identified 46.2% of women as having high-risk pregnancies, but they only referred 17.5% of these women to King Fahad Hofuf Hospital for obstetric consultation. However, at least 6 major PHC centers had an obstetrician on staff. Causes in reproductive history were responsible for classifying 67.4% of the high-risk pregnancies. These causes included grandmultiparity (65%), abortion (12%; 8.3% - 2 abortions), previous Cesarean section (5.8%), RH negative (4.8%), young primipara (4.5%), and other causes, including history of preeclampsia, neonatal death, congenital anomalies, and low birth weight. Associated medical conditions made up the next highest class of high-risk pregnancies (25.4%). These conditions were sickle cell anemia (69.7%), diabetes (17.1%), hypertension (10.4%), and other causes (e.g., chronic bronchitis). Causes in current pregnancy comprised 7.2% of high-risk pregnancies and included non-sickle cell anemia (34.6%), bleeding (12%), malpresentation (17%), twins (14%), urinary tract infection (7%), and other causes (e.g., ectopic pregnancy). 67.7% of women with high-risk pregnancies delivered at King Fahad Hofuf Hospital, 28.8% at PHC centers, 7.1% at medical services of ARAMCO, and 2.4% outside of Al-Hassa area. 94% and 0.8% of high-risk pregnancy cases had unassisted and assisted vaginal births, respectively. The remaining cases delivered by Cesarean section.
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PMID:Prenatal care in primary health care centers of Al Hassa, Saudi Arabia. 129 49

The study group consisted of 82 primigravid and 55 multiparous women with post term pregnancy, preeclampsia, intrauterine growth retardation, insufficiency of placenta and diabetes mellitus have induced labor. Prepidil (Upjohn) in dosage 0.5 mg was given into uterine cervix of 46 patients (PG group) and oxytocin was infused to 42 patients in dosage ranged from 5 mU/min to 30 mU/min (Ox group). Induction of labor has been considered as successful, if after 12 hours of drug administration, regular contractions of uterus and dilation of cervix more than 3 cm were obtained. Significant improvement of cervix state, measured by Bishop score has been observed only in PG group, even if the induction of labor failed. Similar rates of caesarean sections and the same occurrences of late and variable decelerations have been observed in both study groups. Results obtained in both these groups suggest that induction of labor in such pregnancies after prostaglandins administration is more effective than oxytocin infusion.
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PMID:[Induction of labor by using PGE2 and oxytocin in high risk pregnancies]. 130 12

Uteroplacental and cerebral artery velocimetry is a predictive factor in the outcome of many high-risk pregnancies. Positive predictive value is good for intrauterine growth retardation (complications due to preeclampsia, diabetes or twin pregnancy). Velocimetry is also a predictor of adverse outcome in small for gestational age fetuses and for oligohydramnios but not for anemic fetuses of isoimmune pregnancies or post-term pregnancies.
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PMID:[Contribution of Doppler in fetal prognosis]. 133 52

The authors revealed during dispensarization of pregnant women suffering from essential hypertension that the disease is relatively frequently associated with some metabolic disorders, i. e. obesity, gestational diabetes or impaired glucose tolerance. They draw attention to a similarity with Reaven's syndrome in non-pregnant women. The authors recommend to screen for diabetes all obese pregnant women and those with hypertension to detect an impaired glucose metabolism and prevent foetopathies in neonates of thus affected mothers. The authors consider obesity one of the subsidiary criteria in the differential diagnosis of essential hypertension and preeclampsia.
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PMID:[Gestational diabetes mellitus and disorders of glucose tolerance in pregnant women with essential hypertension]. 149 70

During a period of 3 months, a nationwide perinatal census was carried out covering a total of 30 obstetric wards in 27 Israeli hospitals, and the records of all births from a questionnaire were prospectively examined. There were 22,815 births in the country. 90.4% of the deliveries were completed vaginally and 9.6% by Cesarean section (80% as an emergency procedure). The perinatal mortality rate was 13.5/1000. 1080 women who had one previous Cesarean birth were compared to 14,703 women with a previous vaginal birth. From those with one previous Cesarean section, 55.1% delivered vaginally and 44.9 abdominally. According to a logistic regression analysis, breech presentation and one uterine scar were the most important risk factors for Cesarean section as opposed to breech presentation, maternal disease, and multiple pregnancy for perinatal mortality. The national Cesarean section rate in breech presentation was 57.8%. The chance for vaginal delivery was 67.2%, provided the woman had delivered vaginally. The indication for a repeated cesarean section were a previous Cesarean section (28.7%) and malpresentation (12.8%). Uterine rupture ensued in 1.2% (13 cases) of post Cesarean women giving vaginal birth and in only .02% (4 cases) among those who had no previous Cesarean section (P0.001). Comparison between primiparas (42000 deliveries or 18.4% of the total) and multiparas showed that preeclampsia, hypertension, and diabetes mellitus were significantly more frequent among older patients. Preeclampsia and hypertension were more common among primiparas than multiparas (P0.001). In grand multiparity (7th or more parity) diabetes, hypertension, malpresentations, multiple births, large-for gestation age deliveries, and perinatal deaths were significantly more common. The mean birth weight was 3,222 +or- 551 g and the low birth weight (less than 2500 g) was 6.9% with nonsignificant differences between the various ethnic groups. Perinatal mortality was higher for infants born in breech presentation than in cephalic presentation, 23/1000 compared to 3.2/1000, respectively. The level of obstetrics in Israel was measured by the perinatal mortality and the Cesarean section rate was comparable to that of Great Britain, Norway, the Netherlands, and France.
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PMID:The Israel perinatal census. 150 38


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