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Pregnancy outcome in patients with insulin-dependent diabetes mellitus with preconceptional diabetic control: A comparative study
Citations from the Literature
Glycosylated hemoglobin and protein levels in normal and diabetic pregnancies: Relation to birth weight Fade1 HE; Elseweidy MM; Abraham EC
261
Metastatic phenochromocytoma in pregnancy and fetal biophysical assessment after maternal administration of alpha-odrenergic, beta-adrenergic, and dopamine antagonists Devoe LD; O’Dell BE; Castillo RA; et al.
Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Section, Medical College of Georgia, Augusta, GA 30912, USA
Department of Obstetrics and Gynecology, of Georgia, Augusta, GA, USA
OBSTET. GYNECOL.; 6714 (533-536) 1986 Glycosylated hemoglobin and protein were measured in maternal and cord blood of 24 normal, 19 class A, and ten insulin-treated diabetics using an affinity chromatographic technique. Maternal (intrapartum) glycohemoglobin and glycoprotein levels in the diabetics were not significantly different from those in normal controls, suggesting ‘tight’ metabolic control in these patients. Compared with controls, cord blood glycohemoglobin and glycoprotein levels were significantly higher in insulin-treated, but not in class A, diabetics. The birth weight ratio correlated significantly only with maternal glycohemoglobin in insulin-treated diabetics. 1, ..-- 1_ __._II -__r__ll__l :-_.11_ -_ _____,I_-._-_^A IILC:resu,zs suggesr -L-r_ rnal: I, e”ti‘L ln WOuC”‘ILr”LWuInsIWntreated diabetics, the fetuses are hyperglycemic; 2) maternal glycohemoglobin correlates with birth weight in insulintreated diabetics; 3) maternal glycoprotein determinations cannot be used to predict birth weight; 4) hyperglycemia cannot be the sole determinant of fetal overgrowth in diabetic pregnancies; 5) factors influencing fetal overgrowth in class A and insulin-treated diabetics may be different,
OBSTET. GYNECOL.; 68/3 SUPPL. (15S-18s) 1986 Metastatic pheoctiomocytoma, a rare complication of pregnancy, was managed from 30 weeks’ gestation until delivery three weeks later with a combination of alphaadrenergic blockade (Minipres) beta-adrenergic blockade (Timolol), and dopamine synthesis inhibition (Demser). The biophysical parameters of fetal heart rate (FHR) baseline, variability, and reactivity, as well as fetal breathing movements, body movements, tone, and amniotic fluid volume were followed sequentially during this period. A 1450-g growth-retarded infant, who subsequently did well, was delivered by cesarean section; the mother received combi,ed s,urgiG ai;d 111cul~itl -^-1:--I .I. ^_^__. r__ ..~ ulclap,y 101 1_^_ IL~:I I-~~~~ rnerasrarlc disease in the post-parturn period. The initial fetal biophysical alteration observed was a reduction in mean FHR baseline rate; further biophysical test abnormalities appeared only after overt fetal compromise was evident. Sequential mutliple parameter biophysical testing in such circumstances appears to be a valid and valuable approach to antepartum management.
Medical College
Endodennal sinus tumor of the ovary associated with pregnancy Maione JM; Gershenson DM; Creasy iii<; et ai. Pregnancy outcome in patients with insulin-dependent diabetes mellitus with preconceptional diabetic control: A comparative study Goldman JA; Dicker D; Feldberg D; et al. Department of Obstetrics and Gynecology, Golda Meir Medical Center (Hasharon Hospital), Petah Tikva 49372, Israel
AM. J. OBSTET. GYNECOL.; 155/2 (293-297) 1986 Forty-four of 75 pregnant women with juvenile-onset insulin-dependent diabetes, who attended a preconceptional clinic, were seen regularly by a diabetologic team. Glycemic control was obtained by intensified insulin therapy and monitored by blood D vlnrnw cnlf-mnnitnrino ____ “_ I-_...___..” . .. .~ %.es these patients were compared with a group of 31 nonattenders of the preconceptional clinic, in the former normoglycemia and normal hemoglobin Asub 1 values were achieved before conception, whereas in the latter good control was reached by the second trimester. This group had also more maternal complications, such as preeclampsia, and higher cesarean section rates. Congenital anomalies were 9.6% among offspring of nonattenders, while none occurred in those with preconceptional counseling. We confirm the evidence accumulated in the recent literature that congenital malformations in pregnancy complicated by diabetes may be linked to disturbances in maternal metabolism during the period of embryogenesis. Consequently we concur with the recommendation that tight diabetic control is required before the patient attempts to conceive.
Department of Gynecology, The University of Texas, M.D. Anderson Hospital and Tumor Institute, Houston, TX, USA
OBSTET. GYNECOL.; 68/3 SUPPL. (86S-89s) 1986 The association of endodermal sinus tumor of the ovary with pregnancy is a rare event. Reported is a patient with stage Ic endodermal sinus tumor diagnosed in the 25th week of gestation. She received two cycles of combination chemotherapy consisting of vinblastine, bleomycin, and cisplatin, and delivered a healthy male infant by cesarean section at 32 weeks’ gestation. She subsequently completed three more cycles of chemotherapy and remains alive and well. This is the first reported case of a patient with endodermai sinus tumor treated with combination chemotherapy during pregnancy that had a successful outcome for both mother and infant. The literature concerning the association of endodermal sinus tumor and pregnancy and the use of chemotherapy during pregnancy is reviewed. Ultrasound evaluation of amniotic fluid: Outcome of preg. nancies with severe oligohydramnios Bastide A; Manning F; Harman C; et al. Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, (+zivtrrsity of Manitoba, Winnipeg, Man., Canada AM. I. OBSTET. GYNECOL.; 154/4 (895 -900) 1986
Severe oligohydramnios, defined as a condition in which the largest pocket of amniotic fluid measures less thall 1 cm in its vertical axis as determined by an ultrasound method, Int J Gynaecol Obstet 25
Glycosylated hemoglobin and protein levels in normal and diabetic pregnancies: Relation to birth weight Fade1 HE; Elseweidy MM; Abraham EC
261
Metastatic phenochromocytoma in pregnancy and fetal biophysical assessment after maternal administration of alpha-odrenergic, beta-adrenergic, and dopamine antagonists Devoe LD; O’Dell BE; Castillo RA; et al.
Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Section, Medical College of Georgia, Augusta, GA 30912, USA
Department of Obstetrics and Gynecology, of Georgia, Augusta, GA, USA
OBSTET. GYNECOL.; 6714 (533-536) 1986 Glycosylated hemoglobin and protein were measured in maternal and cord blood of 24 normal, 19 class A, and ten insulin-treated diabetics using an affinity chromatographic technique. Maternal (intrapartum) glycohemoglobin and glycoprotein levels in the diabetics were not significantly different from those in normal controls, suggesting ‘tight’ metabolic control in these patients. Compared with controls, cord blood glycohemoglobin and glycoprotein levels were significantly higher in insulin-treated, but not in class A, diabetics. The birth weight ratio correlated significantly only with maternal glycohemoglobin in insulin-treated diabetics. 1, ..-- 1_ __._II -__r__ll__l :-_.11_ -_ _____,I_-._-_^A IILC:resu,zs suggesr -L-r_ rnal: I, e”ti‘L ln WOuC”‘ILr”LWuInsIWntreated diabetics, the fetuses are hyperglycemic; 2) maternal glycohemoglobin correlates with birth weight in insulintreated diabetics; 3) maternal glycoprotein determinations cannot be used to predict birth weight; 4) hyperglycemia cannot be the sole determinant of fetal overgrowth in diabetic pregnancies; 5) factors influencing fetal overgrowth in class A and insulin-treated diabetics may be different,
OBSTET. GYNECOL.; 68/3 SUPPL. (15S-18s) 1986 Metastatic pheoctiomocytoma, a rare complication of pregnancy, was managed from 30 weeks’ gestation until delivery three weeks later with a combination of alphaadrenergic blockade (Minipres) beta-adrenergic blockade (Timolol), and dopamine synthesis inhibition (Demser). The biophysical parameters of fetal heart rate (FHR) baseline, variability, and reactivity, as well as fetal breathing movements, body movements, tone, and amniotic fluid volume were followed sequentially during this period. A 1450-g growth-retarded infant, who subsequently did well, was delivered by cesarean section; the mother received combi,ed s,urgiG ai;d 111cul~itl -^-1:--I .I. ^_^__. r__ ..~ ulclap,y 101 1_^_ IL~:I I-~~~~ rnerasrarlc disease in the post-parturn period. The initial fetal biophysical alteration observed was a reduction in mean FHR baseline rate; further biophysical test abnormalities appeared only after overt fetal compromise was evident. Sequential mutliple parameter biophysical testing in such circumstances appears to be a valid and valuable approach to antepartum management.
Medical College
Endodennal sinus tumor of the ovary associated with pregnancy Maione JM; Gershenson DM; Creasy iii<; et ai. Pregnancy outcome in patients with insulin-dependent diabetes mellitus with preconceptional diabetic control: A comparative study Goldman JA; Dicker D; Feldberg D; et al. Department of Obstetrics and Gynecology, Golda Meir Medical Center (Hasharon Hospital), Petah Tikva 49372, Israel
AM. J. OBSTET. GYNECOL.; 155/2 (293-297) 1986 Forty-four of 75 pregnant women with juvenile-onset insulin-dependent diabetes, who attended a preconceptional clinic, were seen regularly by a diabetologic team. Glycemic control was obtained by intensified insulin therapy and monitored by blood D vlnrnw cnlf-mnnitnrino ____ “_ I-_...___..” . .. .~ %.es these patients were compared with a group of 31 nonattenders of the preconceptional clinic, in the former normoglycemia and normal hemoglobin Asub 1 values were achieved before conception, whereas in the latter good control was reached by the second trimester. This group had also more maternal complications, such as preeclampsia, and higher cesarean section rates. Congenital anomalies were 9.6% among offspring of nonattenders, while none occurred in those with preconceptional counseling. We confirm the evidence accumulated in the recent literature that congenital malformations in pregnancy complicated by diabetes may be linked to disturbances in maternal metabolism during the period of embryogenesis. Consequently we concur with the recommendation that tight diabetic control is required before the patient attempts to conceive.
Department of Gynecology, The University of Texas, M.D. Anderson Hospital and Tumor Institute, Houston, TX, USA
OBSTET. GYNECOL.; 68/3 SUPPL. (86S-89s) 1986 The association of endodermal sinus tumor of the ovary with pregnancy is a rare event. Reported is a patient with stage Ic endodermal sinus tumor diagnosed in the 25th week of gestation. She received two cycles of combination chemotherapy consisting of vinblastine, bleomycin, and cisplatin, and delivered a healthy male infant by cesarean section at 32 weeks’ gestation. She subsequently completed three more cycles of chemotherapy and remains alive and well. This is the first reported case of a patient with endodermai sinus tumor treated with combination chemotherapy during pregnancy that had a successful outcome for both mother and infant. The literature concerning the association of endodermal sinus tumor and pregnancy and the use of chemotherapy during pregnancy is reviewed. Ultrasound evaluation of amniotic fluid: Outcome of preg. nancies with severe oligohydramnios Bastide A; Manning F; Harman C; et al. Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, (+zivtrrsity of Manitoba, Winnipeg, Man., Canada AM. I. OBSTET. GYNECOL.; 154/4 (895 -900) 1986
Severe oligohydramnios, defined as a condition in which the largest pocket of amniotic fluid measures less thall 1 cm in its vertical axis as determined by an ultrasound method, Int J Gynaecol Obstet 25