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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The 50 g oral glucose challenge test (50gGCT) was performed on 622 pregnant women, and 75 g oral glucose tolerance test (75gGTT) was further done on subjects with screening tests value of > or = 7.78 mmol/L. The results showed that there were 16.56% (103/622) women with screening value of > or = 7.78 mmol/L, among whom, 32 were identified as having gestational impaired glucose tolerance (GIGT) and 12, gestational diabetes mellitus (GDM) by confirmatory test of 75gGTT. The sensitivity of 50gGCT was 42.72%(44/103). The incidences of edema-proteinuria-hypertension syndrome (EPH-syndrome), premature rupture of membranes, fetal macrosomia, operative deliveries and perinatal morbidity were higher in women with GIGT/GDM than in women without GIGT/GDM. It suggests that 50gGCT is an ideal method of screening for GDM and should be performed on all pregnant women.
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PMID:Prospective studies on the relationship between the 50 g glucose challenge test and pregnant outcome. 872 43

This study presents kinetic parameters of glycine metabolism during pregnancy and the influence of fuel availability on fetal growth. The kinetic studies were done on patients with gestational diabetes mellitus (diet treated) and pre-gestational diabetes mellitus (diet and insulin treated) that was accompanied by increased fetal growth and pregnancy-induced hypertension and, during the third trimester of pregnancy, by intrauterine growth retardation. Gas chromatography-mass spectrometry was used to determine the 15N enrichment of plasma glycine, and to calculate the pool sizes, turnover rate constants, fluxes and metabolic clearance rates. Glycine pool sizes in pre-gestational diabetes were significantly larger than those in normal, hypertensive and gestational diabetes pregnancies. Glycine turnover rate constants and metabolic clearance rates were not significantly different between the normal pregnant women, the hypertensive, and the two diabetic groups of pregnant women. Glycine fluxes were significantly higher in the pre-gestational diabetic pregnant women than in those with gestational diabetes, hypertension, and normal pregnancy. Pre-gestational diabetic pregnant women delivered fetuses with higher birthweights than the other three groups. Fetal birthweight of the hypertensive women was significantly lower than among the normal and diabetic women. Stable isotope methodology using labeled amino acids provides a powerful tool for clinical studies of maternal protein metabolism and its relationship to fetal growth.
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PMID:Dynamic parameters of maternal amino acid metabolism and fetal growth. 875 79

To investigate the impact of insulin secretion on pregnancy outcome, we studied 102 patients at risk for glucose intolerance between 28 and 34 weeks of gestation. All patients had a 3-hour oral glucose tolerance test (OGTT, 100 g glucose), and glucose and insulin plasma levels were assayed: 32 patients had a gestational diabetes (GDM); 25 had an impaired gestational glycemic tolerance (IGGT), and 45 with normal OGTT constituted the control group. No significant difference between groups was seen for pregnancy outcome. Based on the mean +/- 2 SD of insulin secretion of the control group, IGGT/GDM patients were classified as normoinsulinemic (34 patients), hyperinsulinemic (17 patients), or hypoinsulinemic (6 patients). The hyperinsulinemic IGGT/ GDM group showed a greater incidence of pregnancy-induced hypertension (p < 0.03), while the percentile birth weight was significantly lower (p < 0.01) with respect to normo-hypoinsulinemic patients. Moreover a higher glucose/ insulin ratio was significantly related to birth weight (p < 0.01). Our results suggest an impact of insulin secretion on pregnancy outcome and support the importance of determining the insulinemic pattern in pregnant patients at risk for glucose intolerance.
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PMID:Insulin plasma levels in pregnant patients with impaired glucose tolerance: relationship with pregnancy outcome. 884 Jan 71

We compared the criteria for diagnosis of gestational diabetes mellitus (GDM) of the National Diabetes Data Group (NDDG) and the World Health Organization (WHO) and studied the outcomes of pregnancy. A 50-g glucose screening test and 75-g oral glucose tolerance test (OGTT) were scheduled for 709 pregnant women in the same week between the 24th and 28th week of pregnancy. Blood glucose was measured 1 h after the 50-g glucose screening test and if found to be 7.8 mmol/l or more, a 100-g OGTT was scheduled within 7 days after a 75-g OGTT. The prevalence of GDM was found to be 1.4% (10/709) and 15.7% (111/709) by NDDG and WHO criteria (2 h > or = 7.8 mmol/l), respectively. Using NDDG criteria, all the GDM patients had abnormal 75-g OGTT by WHO criteria. NDDG and WHO criteria were significantly different when compared with normal OGTT by each criteria for age, BMI, pregnancy-induced hypertension, Caesarian delivery, macrosomia and neonatal hypoglycaemia. Of 14 women with macrosomic infants 6 had an abnormal WHO test while only 3 of 14 had an abnormal NDDG test. These findings suggest that WHO criteria GDM patients had significantly worse outcomes of pregnancy and fewer perinatal complications were missed than with the more cumbersome NDDG criteria, and no case of GDM as diagnosed by NDDG criteria was missed.
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PMID:Comparison of National Diabetes Data Group and World Health Organization criteria for detecting gestational diabetes mellitus. 887 91

We characterised the 24-h arterial pressure (AP) profile and the left ventricular (LV) structures and functions in pregnant women with pregnancy-induced hypertension (PIH) or gestational diabetes mellitus (GDM). Thirty pregnant women after 20 weeks' gestation--(10 normotensive; 10 with PIH; and 10 with GDM)--were investigated haemodynamically using 24-h AP monitoring and Doppler echocardiography for determination of LV structures and functions, both systolic and diastolic. The PIH women had significantly higher AP determinations throughout the 24 h, with no change in the diurnal variation, ie, nocturnal decline and early morning peaks. The LV mass was greater in PIH and GDM than in the normotensive women, despite normal AP in GDM. The increased LV mass in GDM was mainly due to LV dilatation and not to increased thickness of its walls. In PIH, the increase in AP was due to peripheral vasoconstriction, while cardiac output was preserved. The LV systolic functions did not differ among the three groups. However, a slight reduction in the myocardial contractility was found in PIH and GDM. The LV relaxation was significantly impaired in both PIH and GDM. Thus, GDM and PIH, although differing in their 24-h AP profile, are characterised by LV hypertrophy and reduction in diastolic function.
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PMID:Gestational diabetes mellitus and hypertension in pregnancy: hemodynamics and diurnal arterial pressure profile. 889 33

The purpose of this study was to determine if early adolescence imparts a significant obstetric risk in young primiparas relative to adult primiparas. The records of 239 young primiparas (< 16 years) and 148 older primiparas (18-29 years) were reviewed for demographic information, antepartum complications, mode of delivery, length of labor, episiotomy, lacerations, birthweight, and length of gestation. The young adolescents were shorter, had an earlier age at menarche, a lower pregravid body mass index, and a higher gestational weight gain. The young teens were less likely to smoke cigarettes but were more likely to be Medicaid recipients. The incidence of most antenatal complications (chronic hypertension, pregnancy-induced hypertension, placental abruption, placenta previa, premature rupture of the membranes, urinary tract infections, and anemia) were similar between the two groups. Preterm labor and contracted pelvis were more common among the young adolescent, while gestational diabetes was less common. The young primiparas were significantly (P < .05) less likely to have a Cesarean delivery and to lacerate with vaginal delivery. The length of labor and its stages were similar, as were overall birthweight and length of gestation. Thus, obstetric concerns regarding pregnancy in early adolescence may be unfounded. With the exception of an increased risk for preterm labor, it appears that pregnancy, labor, and delivery do not pose inordinate obstetric and medical risk to the very young adolescent primipara.
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PMID:Pregnancy in early adolescence: are there obstetric risks? 897 10

We analysed the results of oocyte donation to women of advanced reproductive age (> or = 45 years old) and followed their pregnancies through to delivery in order to assess obstetrical outcomes. Patients (n = 162) aged 45-59 years (mean +/- SD; 47.3 +/- 3.4 years) underwent 218 consecutive attempts to achieve pregnancy. Oocytes (16.2 +/- 7.2 per retrieval) were provided by donors < or = 35 years old. Cleaving embryos (8.2 +/- 4.8 zygotes/couple) were transferred transcervically (4.5 +/- 1.1 per embryo transfer) to recipients prescribed oral micronized oestradiol and intramuscular progesterone. Following oocyte aspiration there were six instances of non-fertilization (2.8%) and 212 embryo transfers. A total of 103 pregnancies was established for an overall pregnancy rate (PR) of 48.6%, which included 17 preclinical pregnancies, 12 spontaneous abortions, and 74 delivered pregnancies (clinical PR 40.6%; delivered PR 34.9%). Multiple gestations were frequent (n = 29; 39.2% of pregnancies) and included 20 twins, seven triplets, and two quadruplets. Two of the triplet and both of the quadruplet pregnancies underwent selective reduction to twins. Antenatal complications occurred in 28 women (37.8% of deliveries) and included preterm labour (n = 9), gestational hypertension (n = 8), gestational diabetes (n = 6), carpel tunnel syndrome (n = 2), pre-eclampsia (n = 2), HELLP syndrome (n = 2), and fetal growth retardation (n = 2). 48 (64.8%) deliveries were by Caesarean section. The gestational age at delivery for singletons was 38.3 +/- 1.3 weeks (range 35-41 weeks), with birth weight 3218 +/- 513 g (range 1870-4775 g); twins 35.9 +/- 2.0 weeks (range 32-39 weeks), birth weight 2558 +/- 497 g (range 1700-3450 g); and triplets 33.5 +/- 0.7 weeks (range 32-34 weeks), birth weight 1775 +/- 190 g (range 1550-2100 g). Neonatal complications (4.6% of babies born) included growth retardation (n = 2), trisomy 21 (n = 1), ventricular septal defect (n = 1), and small bowel obstruction (n = 1). There were no maternal or neonatal deaths. We conclude that oocyte donation to women of advanced reproductive age is highly successful in establishing pregnancy. However, despite careful antenatal screening, obstetrical complications are common, often secondary to multiple gestation.
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PMID:Oocyte donation to women of advanced reproductive age: pregnancy results and obstetrical outcomes in patients 45 years and older. 898 Nov 51

The authors review various aspects of gestational diabetes, including definition, screening, diagnostic procedures, complications (hypertension, macrosomia), clinical evaluation (ultrasound, non-stress test), treatment (diet, insulin), indications for delivery and neonatal aspects (hypoglycaemia, hypocalcaemia). Complications can be reduced by intensive dietary treatment and insulin. If the gestational diabetes is regulated well the woman can wait for spontaneous birth at term. In the case of pregnant women with less than optimal regulated diabetes, however, or with complications such as hypertension, macrosomia, previous stillbirth, labour can be induced preterm by local administration of prostaglandin or infusion of oxytocin. Physical training and weight reduction should be instituted to avoid later development of type II diabetes mellitus. There is still some uncertainty about different aspects of gestational diabetes.
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PMID:[Pregnancy in diabetes]. 926 87

Increased physical activity should be part of the treatment for non insulin-dependent diabetic patients. Increased physical activity delays the onset of non insulin-dependent diabetes mellitus (NIDDM) or even prevents the disease in about 50% of susceptible individuals (positive family history of NIDDM, body-mass index > 25, hypertension or gestational diabetes). Regular exercise has been shown to lower plasma triglyceride and to increase high-density lipoprotein cholesterol levels. Exercise has also beneficial effects on hypertension, body composition and fat distribution. Improved glucose tolerance has been achieved in type II diabetic patients in as little as one week with an exercise program. The beneficial effect of regular exercise on glucose control appears to reflect the cumulative effect of transient improvement in glucose tolerance following each individual bout of exercise. Increased insulin sensitivity is lost after as little as three days of inactivity. Most studies suggest that the maximum benefit from exercise is most likely to occur in patients with mild diabetes in whom insulin resistance and hyperinsulinemia are present (i.e. patients with fasting blood glucose of < 11 mM). The recommended frequency and duration of exercise is three times per week or every other day and, as adjunct for weight reduction, five to seven times per week for 30 to 45 min. at an intensity of 50 to 70% VO2max (or 60 to 80% of maximal the heart rate). Because of the high incidence of ischemic heart disease in type II diabetic patients, patients older than 35 years of age should undergo a graded exercise stress electrocardiogram. Attention should be paid to foot-care and the use of appropriate footwear and diabetic late complications, such as autonomic and peripheral neuropathy. Older obese NIDDM patients can achieve significant metabolic benefits from low-intensity programs, such as daily walking, which can be easily incorporated into daily living. Taking the necessary precautions, most patients with diabetes can take part in a monitored exercise program safely.
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PMID:[Role of physical activity in the therapy and prevention of Type II diabetes mellitus]. 903 70

In 1991 the prevalence of diabetes was 7.6% in women in nine Brazilian state capitals. This disease now ranks among the leading causes of death in the country and is becoming an increasingly alarming public health problem. In spite of advances in the treatment of diabetes and improved obstetric care, gestational diabetes puts a pregnant woman at high risk of spontaneous abortion, ketoacidosis, hypoglycemia, hypertension, and other serious disorders. This study used life histories to investigate the relationship between health, sexuality, and work in five working women who were diabetic and pregnant and who received care at the Prenatal Care Outpatient Clinic of the San Pablo Hospital. All these women had non-insulin-dependent diabetes mellitus, were between 26 and 43 years old, and earned from US$ 150 to 375 per month for working 8-hours days, with one day off each week. Two of the women's male partners were unemployed; all of the women performed household chores during their day off. Quotations taken directly from conversations with the five participants reveal: the difficulty of caring for children and working; the sexual harassment that some of them suffered; the conflict and dissatisfaction associated with work; the myth of the natural joy of motherhood; the sexual control exercised by males; the interference of working conditions and work activities with pregnancy; and the perception that they did not have legal protection owing to employers' lack of respect for workers' rights and for the maternity protection provisions of the Federal Constitutional of Brazil. It is concluded that health policies should pay greater attention to improving the quality of life of working women, especially if they suffer from diabetes and are pregnant.
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PMID:[Work and high-risk pregnancy due to diabetes: two incompatible circumstances]. 916 93


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