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

225 women with diabetes in pregnancy were managed by a team of obstetricians, physicians (endocrinologists) and paediatricians from the National University of Singapore. A protocol of management was formulated and followed. The incidence of 1.1% or 1 in 90 pregnancies was found, with significantly higher incidence in Indians and lower in Malays. There were 37 established diabetics and 188 diagnosed during pregnancy. Of these (188), 74 were gestational diabetics. All the women were treated with Insulin and Diet or Diet alone. 177 (79%) were treated with Insulin and Diet. Blood sugar profiles were done for monitoring diabetic control. 72.8% of the women were between para 0 and 1 and 85.2% between the ages of 20 and 34. 72.5% of the women delivered at 38 weeks gestation or later. 48.9% went into spontaneous labour, 32.4% were induced and 18.7% had elective caesarean section. 62.2% of the women had labour of less than 12 hours. The overall caesarean section rate was 41.7%. There were 3 stillbirths and 2 neonatal deaths. The perinatal mortality rate was 2.2%. Thirteen babies had congenital malformations (5.8%). 77.8% of the babies had Apgar score of 7 or more at 5 minutes after delivery. 79.1% of the babies weighed between 2.5 kgm and 3.9 kgm. Pre-eclamptic toxaemia was the commonest complication in pregnancy followed by Urinary Tract Infection and Polyhydramnios. Postpartum complications in the mother were confined to 14 women (6.2%), and wound infection or breakdown was the commonest cause.
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PMID:Combined team management of diabetes mellitus in pregnancy. 403 89

A new form of obstetric imaging using nuclear magnetic resonance (NMR) has been assessed for use in pregnancy. A total of 92 examinations were performed in 62 women during the second and third trimesters in both normal and complicated pregnancies including 14 with diabetes, six with pre-eclampsia and four with intrauterine growth retardation. Our experience has shown that NMR imaging gives excellent differentiation of both maternal and fetal tissues, and because of complete penetration both superficial and deep structures have been clearly identified. The best fetal images were obtained most consistently in the third trimester providing good detail of brain, lungs, liver, heart, bladder, subcutaneous fat, placenta and umbilical cord while maternal tissues were clearly seen at all gestations. As this form of imaging uses no ionizing radiation it offers an alternative means with unique capabilities for investigating pregnancy.
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PMID:Nuclear magnetic resonance imaging--a new look at the fetus. 405 44

In response to a recent editorial advocating use of prostaglandins (PGs) for preterm labor induction in women with essential and renal hypertension, preeclampsia, growth-retarded fetuses, diabetes, and rhesus incompatibility, this letter questions the logic of such a recommendation. Given that PGF2 alpha has been shown to have a vasconstrictive effect on placental veins and on umbilical arteries; that hypertensive states in pregnancy may cause pathological lesions in uteroplacental arteries; and that preeclampsia involves an inadequate response of the uteroplacental arteries to placentation; PG induction of labor may exacerbate the conditions of complicated pregnancy which necessitated labor induction in the first place. Use of PGs for premature induction of labor in pregnancies by hypertensive states, and perhaps in other conditions associated with intrauterine hypoxia, may aggravate fetal distresses. The letter suggests that in vitro biopsy studies of human pregnanted uterus need to be perform to investigate the action, if any, of PGs on myometrial blood vessels before PGs can be recommended for premature labor induction in cases of hypoxia and fetal distress.
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PMID:Letter: Prostaglandins and induction of labour. 413 41

Using PIXE (proton-induced X-ray emission), we simultaneously determined the concentrations of Se, Ca, Fe, Cu, Zn, Br, and Pb in blood serum from 56 pregnant women, 25 healthy controls, and 31 others with twin pregnancy or some complicating condition (diabetes, hypertension, epilepsy, hepatosis gravidarum, pre-eclampsia, small baby), and in cord-blood serum from 21 newborns. Pellets, pressed from the serum samples after addition of yttrium as an internal standard, mixing, and evaporating at 30 degrees C with or without reduced pressure (less than 1 kPa), were bombarded by 2.2 MeV protons from a Van de Graaff accelerator in the air and the induced X-rays collected by a Ge(Li) detector. Relative to mean Se values for early six- to 12-week pregnancy (0.045 ppm), those for 35-42 week pregnancy (0.028 ppm) were low (p less than 0.001). Umbilical cord blood serum showed even lower values (0.016 ppm, p less than 0.001)--findings in harmony with the incidence pattern of Keshan cardiomyopathy. Pb crossed the placenta; values for cord serum were not significantly different from those in pregnancy serum. Cu, Zn, Fe, and Ca showed the significant expected patterns in the different groups. Compared with the late-pregnancy controls, Fe was high in mothers of small-birth-weight babies (1.70 ppm, p less than 0.02). Br was high in pre-eclampsia (3.59 ppm, p less than 0.05) and mothers with twins (3.61 ppm, p less than 0.05).
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PMID:Selenium and other elements in human maternal and umbilical serum, as determined simultaneously by proton-induced X-ray emission. 632 54

The records of 23 insulin-dependent diabetics who had serial ophthalmological examinations during pregnancy and afterwards were reviewed. Fourteen pregnancies occurred in 10 patients with no retinopathy; 30% of these patients had obstetric complications. The mean birthweight was 3.5 kg. Ophthalmological status was unchanged in this group. In eight patients with background retinopathy during 10 pregnancies the obstetric complication rate was 70% and mean birthweight 3.3 kg. During pregnancy there was no evidence of progression of retinopathy. One patient developed proliferative retinopathy 4 years later. Five patients had proliferative retinopathy. The mean age (32 years) and duration of diabetes at index pregnancy (18 years) was greater than for the other groups. All patients developed pre-eclampsia and mean birthweight was 2.8 kg. Four of these patients required argon laser photocoagulation in association with pregnancy for progressive retinopathy; one died subsequently from end-stage diabetic nephropathy; the other four have maintained their pre-pregnancy visual acuity from 4 to 10 years.
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PMID:Diabetic retinopathy in pregnancy. 636 12

In the present studies, the content and the in vitro production of prolactin by decidua as well as the concentrations of prolactin in amniotic fluid, maternal and fetal serum in normal term pregnancies, induced abortions at various gestational ages, and in pregnancies complicated by diabetes mellitus, preeclampsia, chronic hypertension, and polyhydramnios were measured. Maternal and fetal prolactin levels varied considerably throughout gestation, but at term did not differ significantly between normal and abnormal pregnancies. Prolactin levels in amniotic fluid as well as decidual prolactin content and production were significantly lower only in pregnancies complicated by either hypertension or polyhydramnios. In both normal and abnormal pregnancies, decidual prolactin production correlated strongly with amniotic fluid concentrations. The present data suggest that 1) maternal and fetal prolactin levels do not differ significantly between normal and abnormal pregnancies, 2) the decidua is the principal source of amniotic fluid prolactin, and 3) the significantly lower levels of prolactin in amniotic fluid of pregnancies complicated by hypertension or polyhydramnios are probably due to adverse effects of these conditions on the synthesis and release of prolactin by decidua.
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PMID:Decidual, amniotic fluid, maternal and fetal prolactin in normal and abnormal pregnancies. 636 59

Previous studies differ as to whether the fetus of the woman with diabetes mellitus has altered formation of lung surfactant. The factors responsible for these differences remain unclear. In this study, measures of blood glucose control, including birth weight percentile and the presence of factors potentially influencing fetal pulmonary maturation, such as diabetic class, maternal chronic hypertension, and preeclampsia, were compared with the amniotic fluid lecithin/sphingomyelin ratio, phosphatidylglycerol, and phosphatidylinositol within a group of 90 diabetic pregnancies. The factors were evaluated in combination with the techniques of canonical correlation and multiple regression analysis. Gestational age had the strongest effect in determining levels of amniotic fluid phospholipids, and hypertension was found to significantly accelerate the appearance of phosphatidylgycerol (p less than 0.05). The effect of hypertension was one third as important as that of gestational age. Neither diabetic blood glucose control, White classification, nor the remaining explanatory variables were found to play a significant role in determining the amniotic fluid phospholipid levels. This study suggests that, in the clinical management of diabetes, gestational duration remains the single most important determinant of amniotic fluid phospholipid levels.
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PMID:What affects fetal pulmonary maturation during diabetic pregnancy? 638 16

Pregnancy-specific beta 1-glycoprotein (SP1) concentrations were measured by nephelometry in 133 serum samples from 74 women in their last trimester of pregnancy. All women carried one child but their pregnancies were complicated by pre-eclampsia, essential hypertension, diabetes mellitus or rhesus isoimmunization. Most of the women with pre-eclampsia or essential hypertension who gave birth to infants of normal weight had SP1 values evenly distributed within the reference range. Women with insulin-dependent diabetes mellitus who gave birth to infants to normal birth weight or large-for-date infants had SP1 levels well within the reference range and even showed a tendency to overrepresentation above the geometric mean. Women with rhesus isoimmunization all delivered infants of normal birth weight. Their SP1 values were near or above the geometric mean of the reference range. No special pattern of SP1 levels was observed in relation to the severity of the immunization.
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PMID:Serum levels of pregnancy-specific beta 1-glycoprotein (SP1) in women with pregnancies at risk. 641 36

This analysis is based on the 1972 and 1980 National Natality Surveys, conducted by the National Center for Health Statistics. About 10.6 percent (381,000) of women in the United States who delivered live infants in 1980 were sterilized postpartum. About 93 percent of these postpartum sterilizations were tubal operations; only 1.4 percent were hysterectomies. Because the literature on the health correlates of sterilization is sparse, this analysis was exploratory. In both 1972 and 1980, married mothers were more likely to be sterilized postpartum if they had previous fetal losses, underlying medical conditions, complications of pregnancy, or a cesarean delivery. Inspection of more detailed tabulations reveals that repeat cesarean delivery, multiparity, diabetes and at the higher birth orders, excess weight gain, and toxemia preeclampsia were associated with postpartum sterilization. An apparent association with varicosity may be due to misreporting. The degree to which each of these associations is causal or spurious awaits further research, but preliminary analysis suggests that some maternal health factors may influence some sterilization decisions. Beyond these specific maternal health conditions and complications, the evidence for a connection between poor maternal health and sterilization is equivocal.
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PMID:Social and clinical correlates of postpartum sterilization in the United States, 1972 and 1980. 642 61

One hundred twenty-eight high-risk gravidas and 62 normal gravidas who had undergone placental sonography were compared retrospectively according to placental grade, risk category, and stage of pregnancy at the time of the examination. Pregnancies ranged from 28 weeks of gestation to term. For analysis, the group of high-risk patients was subdivided into four categories representing specific disease states: chronic hypertension and/or preeclampsia, intrauterine growth retardation, maternal diabetes, and Rh sensitization. To eliminate gestational age bias, both the normal group and the high-risk subgroups were further subdivided into preterm and term pregnancies. Placental grade distribution was similar between the high-risk group overall and the normal group, but specific disease entities were associated with widely varying distributions of placental grade. In particular, hypertension and intrauterine growth retardation showed a strong correlation with accelerated placental maturation, whereas diabetes and Rh sensitization were associated with delayed maturation of the placenta. These differences were more pronounced in the preterm population.
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PMID:Distribution of placental grade in high-risk gravidas. 643 17


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