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

In order to evaluate the surfactant maturation of the neonate, tracheal aspirates were analyzed in 84 newborn infants with 12h of birth. Using 2-dimensional thin-layer chromatography, 9 different phospholipids were identified. Dynamic surface tension measurements were performed with a modified Wilhelmy balance. Five different groups of infants with typical phospholipid patterns were characterized: i.e., 1. Normal term newborn. 2. RDS in the preterm infant. 3. Acceleration of lung maturity in preterm infants without RDS. 4. Retardation in term infants with RDS. 5. Therapeutic induction of pulmonary maturity in preterm infants following maternal glucocorticoid administration. Mature lung effluent contains high concentrations of phosphatidylcholine (PC) and phsophatidylglycerol (PG). In infants with RDS, PC is low and PG absent. Accelerated lung maturity was observed after chronic prenatal stress, such as prolonged rupture of the membranes, chronic vaginal bleeding, and maternal hepatitis or drug addiction. Retardation of pulmonary maturity was seen in infants with alpha-1-AT-deficiency, maternal diabetes and maternal hypothyroidism. Administration of methylprednisolone to the mother 24 h to 72h before birth induced both the synthesis of PC and PG in the preterm infants, resulting in an almost full-term phospholipid pattern as early as 31 weeks of gestation. The significance of these factors on the pathogenesis of RDS is discussed.
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PMID:Factors influencing surfactant composition in the newborn infant. 30 91

The efficacy of correlating the L/S ratio in the amniotic fluid with fetal lung maturity has been substantiated in normal pregnancies. In gestations complicated by fetomaternal diseases, however, the assay is less reliable. This study involves 555 pregnancies in which there was a significant maternal, fetal, or placental disorder. The L/S ratio was related to fetal respiratory maturity as measured by Dubowitz criteria and the occurrence of RDS. The results show that pre-eclampsia, chronic hypertension, diabetes (Class D, E, F), significant cardiovascular disease, severe hemoglobinopathies, various congenital anomalies, chronic placental insufficiency, and prolonged ruptured membranes accelerated the L/S ration. Conversely, mild diabetes (Class B, C), intrinsic renal disease, hepatitis, collagen disease, hydrops fetalis, syphilis, and toxoplasmosis were associated with a delay in the L/S ratio. A significant increase in erroneous responses was noted in these patients when the L/S ratio was correlated to infant maturity and to the incidence of RDS. Possible mechanisms for these findings are discussed.
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PMID:The lecithin/sphingomyelin ratio in cases associated with fetomaternal disease. 57 73

In the period between 1973 and 1976, in order to prevent neonatal RDS, 24 insulin-dependent diabetic mothers were given Dexamethason before delivery. The treated group was compared with a control group comprising 26 women of the same gesational age, severity of diabetes and mode of delivery. Neonatal care was similar in both groups. In the group where steroid prophylaxis was applied, decrease of RDS morbidity and mortality was observed. The authors accentuate that Dexamethason given to the mother may have an unfavourable effect on carbohydrate metabolism. Therefore, it is recommended to perform 4-hour determinations of blood sugar, urinary sugar and acetone and accordingly, modification of therapy.
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PMID:[Prevention of respiratory distress syndrome in pregnant diabetic women during labor]. 61 Feb 35

The authors used Dexamethasone before delivery in 577 cases of pregnancy. There were 460 prematurities. Occurrence of RDS was significantly lower in cases, where delivery took place more than 48 hours after the steroid treatment. Where the steroid effect was not optimum (48 hours), the RDS was similar to that of the control group, although mild in form. In their studies they found no connection between the tocolysis (Partusisten) and the occurence of RDS. They emphasize that in the cases where respiratory insufficiencies are predisponated (elective caesarean section, diabetes mellitus etc.) the steroids significantly reduce the frequency of the disease. Neither the number of apoplexy nor that of death due to infections increase in dexamethasone treatment.
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PMID:[Relationship of time interval between steroid therapy and labor to the incidence of respiratory distress syndrome]. 68 65

An experience with the lecithin/sphingomyelin (L/S) ratio in a population of high-risk obstetric patients is presented. A wide range of values in ralation to gestational age was found. A delayed rise in L/S ratio was found in Class A diabetes and Rh sensitization but was most striking in Class B through F diabetes. Chronic hypertension alone or in combination with diabetes is associated with an earlier rise in L/S ratio. A poor correlation of L/S ratio and neonatal pulmonary outcome with birthweight and gestational age was found. However, a good correlation between L/S ratio and neonatal pulmonary outcome was apparent. An L/S ratio of over 2 was universally associated with absence of serious RDS, but a low L/S ratio was less precisely predictive.
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PMID:The lecithin/sphingomyelin ratio in a high-risk obstetric population. 81 62

Dexamethason in a total dose of 15 mg was given in 125 cases of premature labour 48 hours before delivery to prevent the development of respiration distress syndrome. Clinically, the incidence of RDS was 14,5% (18 cases) in the treated group, while in the control group it was 27,7% (32 cases out of 119). Owing to RDS two prematures died in the treated group, and 14 in the control one. Steroid prophylaxis was applied prenatally with 69 pregnant women at term who were predisposed to give birth to infants developing RDS (retardation, diabetes mellitus, elective section caesareas, etc.). Five neonates developed RDS and one died of hyaline membrane disease. The authors studied the effect of steroids on carbohydrate metabolism and total oestrogen excretion in the urine. From profile examinations of blood sugar it was concluded that no pathological alterations take place in maternal carbohydrate metabolism due to intravenous or intermittent prolonged administration of Dexamethason. After one single large dose (15 mg) of Dexamethason a reduction of 30-40% was noted in total oestrogen excretion. Return to the initial value was noted on the 11th-12th day. No appreciable changes were observed with prolonged intermittently given Dexamethason. On the basis of their observations the authors consider that steroid therapy applied during labour is efficient in preventing neonatal RDS.
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PMID:[Prevention of respiratory distress syndrome prior to delivery using steroids]. 89 45

The average estradiol concentrations in umbilical cord plasma from newborns which developed respiratory distress with or without hyaline membrane disease (RDS) were lower by 25% than in controls. Complication of pregnancy by maternal diabetes or pruritus has been associated with abnormalities in estrogen concentrations in the mother, but cord plasma estradiol levels in these cases were essentially normal. Because of reports that treatment of the mother before delivery with estrogens or glucocorticoids results in a decreased incidence of RDS in newborns the relationship between endogenous estradiol and cortisol levels in cord plasm was investigated. There was no significant correlation between the concentrations of these steroids in 65 specimens; the cortisol levels associated with two cases of severe RDS were low.
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PMID:Umbilical cord plasma estradiol levels in relation to complications of pregnancy and newborn and to cortisol levels. 117 1

An analysis of 105 cases of prematures with respiratory distress syndrome, the idiopathic type were 9.5% (10/105). Fetal anoxia and ischemia, induced by pregnancy and during labour amounting to 87.6% (92/105), and of which 2.9% (3/105) was due to diabetes. It indicated that most cases of RDS are predominantly related with fetal anoxia and ischemia which results in pulmonary surfactant abnormality or impaired activity. It is important that in clinical diagnosis one should monitor cautiously the presence of premature birth with anoxia and ischemia, Thus, a preventive treatment must be given at least 24 hours prior to birth, and the earlier the least morbidity of RDS occurred.
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PMID:[Prevention and factors inducing respiratory distress syndrome in prematures]. 139 90

Surfactant proteins A and B (SP-A and SP-B) were measured in human amniotic fluid by ELISA and correlated with lecithin to sphingomyelin ratio (L/S), phosphatidylglycerol (PG), and perinatal outcome. Amniotic fluid SP-A, SP-B, and L/S increased with advancing gestation. SP-A was detected at 19 wk gestation and increased dramatically in the 3rd trimester of pregnancy. SP-B was first detectable at 31 wk gestation and increased significantly to term. SP-A was a more specific predictor of nonrespiratory distress syndrome (RDS) than L/S or SP-B; however, the sensitivity of SP-A in predicting RDS was less than L/S less than 2.0 (26.3 versus 82.3%, respectively). In 209 pregnancies assessed within 48 h of delivery, the sensitivity of SP-B in predicting RDS (nondetectable SP-B) was comparable to the L/S, however, SP-B = 0 was frequently observed in mature infants, limiting its specificity for prediction of RDS. The greatest sensitivity and specificity were achieved with the measurement of L/S less than 2.0 and negative PG, which correctly predicted 100% of the infants with RDS and 94% of those who did not develop the disorder. Measurement of SP-A or SP-B did not improve the prediction of RDS. SP-A, SP-B, and L/S were not affected by infant sex, Apgar score, rupture of membranes, size for gestational age, maternal diabetes, hypertension, or exposure to medications. SP-A, SP-B, and L/S were significantly elevated in amniotic fluid from black mothers. SP-A was significantly elevated in amniotic fluid from mothers who smoked during pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Ontogeny of surfactant proteins A and B in human amniotic fluid as indices of fetal lung maturity. 180 57

Preservation of own insulin production (residual pancreatic beta-cell function) has been shown to have a beneficial effect on glycemic control in insulin-dependent diabetic subjects, and its total lack has been suggested to be an independent risk factor during diabetic pregnancy. We studied the influence of residual beta-cell activity on the glucose control and the outcome of pregnancy in 29 diabetic women by sequentially measuring gestational postprandial plasma C-peptide (CPR) levels, diurnal blood glucose curves and blood glycosylated hemoglobin (Hb A1c) and by analyzing the morbidity and mortality of the offsprings. The 9 diabetics with moderate own insulin secretion (CPR levels over 1.0 microgram/l, White classes B and C, later referred to as group I) had significantly better glucose control than the remaining 20 subjects with lower CPR values (White classes C, D and NF, later referred to as group II) (figure 1, table I). There were two intrauterine deaths, both in group II. These deaths (one caused by multiple congenital contracture syndrome and the other by severe intrauterine growth retardation without any evident cause) could not be straightly connected with diabetes. Respiratory distress syndrome was seen in group II only. There was no other significant difference in the neonatal morbidity between the two groups (table II). All mothers of RDS infants were in White class NF where the birthweight was also smaller than in classes B and C. These were the only differences in neonatal morbidity between the White classes (table III). In conclusion, moderate residual beta-cell function seemed to be clinically important in maintaining strict glucose control during gestation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Maternal residual beta-cell function and the outcome of diabetic pregnancy. 329 78


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