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Query: UMLS:C0029713 (immaturity)
 4,335 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Perinatal morbidity and mortality are increased in both overt and gestational diabetes. Since retardation of placental development has been documented in overt diabetes, we, thus, examined morphometrically the terminal villi of 26 patients with gestational diabetes in order to determine if there is an immaturity of placental development. Investigation of villous surface, degree of vascularization, and development of epithelial plates yielded values lying somewhere between those of non-diabetic patients and those of patients with overt diabetes. Only the surface areas of the vessels were reduced to levels lower than in overt diabetes. Our findings appear to explain the occasional development of acute placental insufficiency.
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PMID:Morphohistometric investigations in placentas of gestational diabetes. 321 Jan 5

The major fetal risk associated with elective delivery is unexpected fetal lung immaturity and the development of hyaline membrane disease soon after birth. Prior to elective vaginal or abdominal delivery it has become standard obstetric practice to predict fetal lung maturity by the analysis of amniotic fluid obtained by amniocentesis or vaginal pool sample following preterm rupture of membranes. A correlation between third-trimester fetal biparietal diameter and the lecithin/sphingomyelin (L/S) ratio has been established by several investigators. In order to determine if a threshold BPD could be consistently correlated with fetal lung maturity, we retrospectively examined the hospital and laboratory records of a group of 115 nondiabetic parturients in whom BPD measurements and amniotic fluid analysis for L/S ratio had been performed for various clinical indications. A threshold BPD of greater than or equal to 9.2 cm in all parturients who underwent elective repeat cesarean delivery was associated with no hyaline membrane disease (HMD). Two of the three neonates who developed HMD had mature L/S ratios but were products of pregnancies complicated by third-trimester hemorrhage. A review of our present data suggests that about one-third of clinically-indicated amniocenteses in the absence of maternal diabetes or third-trimester hemorrhage could potentially be avoided without adverse neonatal impact. Possible therapeutic application of this finding requires further prospective study.
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PMID:Third-trimester biparietal diameter as a predictor of fetal lung maturity. 330 Jun 78

Main indications for antenatal administration glucocorticoid to pregnant women are premature contractions, hemorrhage during pregnancy, conditions of fetal distress and maternal diseases. There are some absolute or relative contraindications as well: severe forms of preeclampsia, diabetes mellitus, premature rupture of membranes, maternal and/intrauterine infections. In a retrospective evaluation of the data obtained at our institution of 637 nonrandomized cases from the years 1980-1985, we could demonstrate the dependence of the therapeutic results on the sex of the newborn. The RDS incidence is significantly different after betamethasone prophylaxis. It was 1/25 (4%) in girls compared to 13/31 (42%) in boys. A marked reduction of the RDS incidence is only detectable after betamethasone therapy from the 32nd to the 34th week of gestation. Thus we recommend RDS prophylaxis for all patients with premature contraction, mainly between the 32nd and 34th week of pregnancy. In addition, it should be given in cases of confirmed lung immaturity. Special restrictions are necessary in cases of preeclampsia, eclampsia, diabetes and confirmed maternal infections. In the group of diabetes or preeclampsia patients an RDS prophylaxis should only be given, if at all, when it can be performed under intensive care conditions.
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PMID:Clinical aspects of antenatal glucocorticoid treatment for prevention of neonatal respiratory distress syndrome. 344 99

In the streptozocin-induced diabetic rat, the placenta is larger and the fetus is smaller than normal. To study cellular differences that might contribute to the size and functional disparity between diabetic and control placentas, a light- and electron-microscopic analysis was performed on 14-, 18-, and 22-day (term) control and diabetic placentas. Diabetic placentas, especially later in gestation, were marked by the presence of large numbers of glycogen-distended cells in the basal zone. Within the placental labyrinth, the trophoblastic layers of the interhemal membrane were significantly thicker in the diabetic placentas on days 18 and 22, and large accumulations of liid droplets were present, especially in the inner two trophoblastic layers. In normal placentas there is a marked thinning of the placental barrier in the labyrinth by day 22 of gestation, making the thickness of the labyrinthine layers in age-matched diabetic placentas even more impressive. Finally, the labyrinth of 22-day diabetic placentas contained more glycogen and rough endoplasmic reticulum in the inner trophoblastic layer, a feature that is found in less-mature (18-day) control placentas. Thus, the diabetic placentas have a number of features that are consistent with functional immaturity/dysmaturity. Cytologic evidence confirms the presence of increased glycogen and lipid reserves in both the junctional zone and the cellular area between maternal and fetal blood.(ABSTRACT TRUNCATED AT 250 WORDS)
Diabetes 1986 Nov
PMID:Fine structural abnormalities of the placenta in diabetic rats. 375 95

An analysis is presented of data on all 30 129 inpatient admissions to a mission hospital in the West Nile District of Uganda in the 27 year period from July 1951 to August 1978. For most of this period the hospital was staffed by the same two doctors. For each patient admitted, a record was made of their age (adult or child), sex, place of residence, duration of stay in hospital, diagnosis and vital status at discharge. The annual number of admissions increased steadily from around 300 in 1952 to over 1600 in 1966 and subsequently declined to about 900 in 1977. Sixty-five per cent of admissions were medical, 12% surgical, 11% obstetric and 9% gynaecological. Thirty per cent of admissions were children (aged 0-9 years). Forty-five per cent of admissions were from those resident in the same county as the hospital and another 20% were from an immediately adjacent county. Infective and parasitic conditions (including respiratory diseases) accounted for over 60% of admissions among children and over 38% of admissions among adults (excluding obstetric patients). The six most common causes of admission were: uncomplicated delivery (2308 admissions), pneumonia (2020), hookworm (1999), malaria (1806), schistosomiasis (1742) and diarrhoea (1041). In total 1960 deaths were recorded (6.5% of all admissions). High case fatality rates were observed for tetanus (61%), immaturity (54%), meningitis (38%), kwashiorkor (21%), other malnutrition (19%) and anaemia (19%). A striking increase in the number of admissions for measles was observed in the period 1976 to 1978. Admission rates for schistosomiasis (S. mansoni) appeared to be highest from counties adjacent to the Nile and 104 deaths were recorded among the 1742 patients with this as the primary diagnosis. Admissions for diabetes, as a percentage of all admissions increased from 0.2% in 1951-54 to 1.5% at the end of the study period. Marked seasonal variations in admission patterns were found for diarrhoea, measles, meningitis and respiratory infections, the last two, but not diarrhoea, being most common in the wettest months. Admissions for malaria showed no strong seasonal associations. Despite the limitations of hospital-based data, it is argued that the data analysed provide a reasonable indication of the important causes of severe morbidity and mortality in the district. Furthermore, some of the changes in admission patterns over time are likely to represent true changes in disease rates rather than artefacts of diagnosis or referral. The analyses presented indicate the value of simple record systems, carefully maintained.
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PMID:Admissions to a rural hospital in the West Nile District of Uganda over a 27 year period. 378 13

Neonatal risk in 172 women with early manifested maternal diabetes mellitus (manifestation less than or equal to 18 years) has been estimated in an analysis of 10 years. We found a tendency towards an increased rate of mortality and malformations, but there are no statistic significant differences compared with the White B group as well as with the C/D-group of late manifestation. An increased risk of morbidity (rate of fetopathy , immaturity, disturbed adaptation) could be demonstrated, but it exists also in the newborns of diabetic mothers of the White group B. Using the recent literature the causes have been discussed and conclusions have been made.
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PMID:[Neonatal risk in early manifested maternal diabetes]. 673 Jul 73

Early studies suggest that transient tachypnea of the newborn is a benign disease of uncertain etiology. Consequently, prevention of this complication has not been a primary concern of obstetricians. In this study of amniotic fluid phospholipids, 55 pregnancies in which the neonate developed transient tachypnea were compared to 355 pregnancies after which respiratory distress did not occur. Thirteen neonatal complications and procedures, often associated with prematurity, were significantly increased in the infants who developed transient tachypnea. Potential risk factors for transient tachypnea were examined by stepwise discriminant analysis. Negative amniotic fluid phosphatidylglycerol, prematurity (less than 38 weeks), and 1-minute Apgar score less than 7 all made an independent contribution to the overall characterization of infants at increased risk for transient tachypnea. These findings suggest that mild fetal lung immaturity may be a factor in the pathophysiology of this syndrome, and that the relationship of perinatal factors associated with transient tachypnea of the newborn in previous studies, including maternal diabetes mellitus and cesarean birth, may be partially mediated through a neonatal surfactant deficiency.
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PMID:Transient tachypnea of the newborn: the relationship to preterm delivery and significant neonatal morbidity. 685 31

Ultrasonography, antepartum testing of the fetal heart rate, and amniotic fluid assays were used in a management protocol to select the optimal time for delivery of a group of 165 pregnancies complicated by diabetes mellitus or hypertensive disorders. Only six cases of intrauterine growth retardation were detected ante partum. Nonreactive nonstress tests were found in 28 pregnancies, and 12 of these also had positive contraction stress tests. Evidence of immaturity from amniotic fluid assay led to a needed delay in the delivery of eight infants. Seven antepartum fetal deaths occurred. Twenty-six infants were delivered prematurely, but there was only one late neonatal death. The uncorrected perinatal mortality for this group of high-risk pregnancies was 47.3 per 1,000 births.
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PMID:Selective delivery in high-risk pregnancy. 724 48

Twenty-one Thai patients with beta-thalassemia/haemoglobin E and haemoglobin H diseases, 8-20-years-old, were studied. These patients had receive none or minimal blood transfusion. The important clinical endocrine abnormalities were growth retardation and sexual immaturity. GH secretion was found to be impaired in the majority of patients. Oral GTT showed chemical diabetes in one out of sixteen tests, a much lower incidence than in thalassaemic patients treated by hypertransfusion in the West. The mean insulin levels basally and after glucose loading were lower than those of the normal controls. Thyroid function was normal in all of the patients. Serum cortisol and 24-h urinary oxogenic steroids 917 OGS) levels were normal, as was adrenal cortical reserve in all the patients. The literature on endocrine function in in thalassaemia is reviewed.
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PMID:Endocrine function in thalassaemia. 726 14

Although fetal lung maturity determination is carried out more and more rarely in the German-speaking area, a reliable information about the degree of lung maturity is still very important in the care of high-risk pregnancies. The side effects and costs of a postpartal surfactant administration can be avoided if lung maturity is proved. Indications for determination of fetal lung maturity are the threatening preterm delivery and the premature rupture of membranes before the 34th week of gestation and uncertain gestational age. Furthermore, in preeclampsia resp. in diabetes mellitus, which is difficult to control, premature delivery may be necessary. To improve lung maturity testing we introduce a new "sequence scheme" containing three lung maturity tests which are easy to carry out (in the following sequence: Amniostat-FLM ultrasensitive, counting of the lamellar bodies in amniotic fluid, surfactant/albumin ratio with TDx-FLM). The principle of this scheme is, that if any of these three tests indicates lung maturity, the sequence is terminated and no further test is performed. Only if all three tests indicated immaturity, the child was at risk for RDS. In 87 amniotic fluid samples with 7 RDS-cases, we achieved high predictive values for lung maturity (specificity 90%, sensitivity 100%, predictive value of positive test 47%, predictive value of negative test 100%). In 62% only one test was needed for lung maturity determination. It is possible to use other combinations in such a scheme (e.g. the L/S ratio). This might lead to equal or perhaps better results. An advantage of this suggested "sequence scheme" is that it can be performed in any clinic.
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PMID:[Prenatal determination of lung maturity from amniotic fluid--indications and new methods]. 785 9


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