Gestational diabetes and impaired glucose tolerance of pregnancy in Riyadh

Citations from the Literature hypoglycemic episodes, subtotal thyroidectomy was performed. A 42% decrease in insulin requirements was observed postoperatively, with return to the euthyroid state. A propensity for symptomatic postoperatively hypoglycemia should be anticipated in diabetic patients undergoing thyroidectomy.

Gestational

diabetes

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lateralis injections as compared with those receiving gluteal muscle injections. The results suggest that intramuscular administration of ritodrine is an efficacious and safe route of drug delivery. Additional studies are needed to better define dose-response curves for the intramuscular administration of ritodrine hydrochloride.

and impaired glucose tolerance of

pregna=YInRiyrdh Al-Shawaf T; Akiel A; Moghraby SAS The Department of Obstetrics and Gynaecoio~, Medical CoC lege, King Saud University, I1411 Riyadh; SaudiAmbia British Journal of Obstetrics and Gynaecology /95/l (84-90)/ 19881 A total of 1088 pregnant women was screened for abnormalities in glucose metabolism at the initial antenatal visit; those with specific risk factors were screened again after 28 weeks gestation. In 210 (19.3%) plasma glucose measured 2 h after a 75 g glucose load was > = 7.8 mmo1/1(140 mg/dl). Follow-up glucose tolerance tests revealed an overall prevalence of abnormal tests of 10.3Vo (112 of 1088) according to the WHO criteria, of which 21 (1.9%) were diagnosed as gestational diabetes, and 91 (8.4Vo) as impaired glucose tolerance. This high prevalence was significantly related to age, parity and body mass index. Screening and diagnosis using criteria set by the WHO were found acceptable and are recommended to help resolve the international disagreement on diagnostic criteria of glucose metabolism abnormalities in pregnancy.

Intramuscular versus intravenous rttodrine hydrochloride for pretenn labor management Gonik B; Benedetti T; Greasy RK; Lee AF-S Division of Maternal-Fetal Medicine, University of Texas Health Science Center at Houston, Houston, TX 77030; USA American Journal of Obstetrics and Gynecology /159/2 (323328) /1988/ A prospective, interinstitutional comparative trial was undertaken to examine the efficacy, safety, and pharmacodynamics of different administration routes of ritodrine hydrochloride for the management of preterm labor. Forty-five subjects between 20 and 36 weeks’ gestation received either intravenous (n = 24) or intramuscular (n = 21) therapy. Successful tocolysis occurred in 14 of 21 (67%) patients in the group treated intramuscularly and in 16 of 24 (67%) patients in the group treated intravenously. A greater mean dose (8.6 versus 3.3 mg/hour) and a higher mean serum concentration (38.9 versus 24.7 mu g/ml) were needed to achieve successful tocolysis in the intravenous group as compared with the intramuscular group. Patients who did not respond to tocolytic therapy in both groups had levels of ritodrine in the blood either equivalent to or greater than those of subjects who were successfully treated. Analysis of ritodrine levels in the successfully treated intramuscular group demonstrated significant differences in blood levels depending on muscle group used. These differences can be at least partially attributed to higher mean doses administered to patients receiving vastus

Musarement of placental alkal&e phospbatass ill maternal phsma as aw hdtcator of subsqpcat low birthweight 011tf0me Brock DJH; Barron L Human Genetics Unit, University of Edinburgh, Western General Hospital, Edinburgh EH4 2XU; UK British Journal of Obstetrics and Gynaecology /95/l (79-83) /1988/ Placental alkaline phosphatase (P-ALP) was measured by a specific monoclonal antibody-based immunoassay in plasma samples of 117 women who subsequently were delivered of an infant of birthweight less than 2.5 kg. P-ALP values > twice the normal median were found in 32% of maternal plasma samples from low birthweight cases in one series and in 35% in another series, while in normal outcome controls the corresponding value was 8%. The differences were highly significant. The proportion of low birthweight cases with elevated maternal P-ALP values appears to be very similar between 15 and 34 weeks gestation. At 16-18 weeks gestation there is a significant positive correlation (r = 0.40) between P-ALP and maternal plasma alpha-fetoprotein (AFP) values in low birthweight cases. The use of P-ALP assay in combination with AFP assay appears to improve the detection of pregnancies with subsequent low birthweight outcome.

Methadone mahltenaacein pregnancy: coMequeners to care and oatcome Edelin KC; Gurganious L; Golar K; Oellerich D; Kyei-Aboagye K; Hamid MA Department of Obstetrics and Gynecology, Boston University School of Medicine, MA 02118; USA Obstetrics and Gynecology /7 l/3 I (399-404) / 1988/ A retrospective analysis was conducted on the outcomes of the pregnancies of 26 narcotic-addicted women who were enrolled in a methadone maintenance program. Of these women, 88% continued to use other drugs during their pregnancy, with opiates the most frequently used, and 56% of these women had urine toxicology screens positive for either heroin, cocaine, or benzodiazepines when they presented in labor. When these women were compared with a similar group of 37 pregnant polydrug users who were not in the methadone maintenance program and who delivered during the same 1Zmonth period, there was no difference in the birth weights or in the infants’ one- and five-minute Apgar scores. However, the women in the methadone maintenance program had more prenatal visits, more adequate prenatal care, and less anemia than the non-methadone maintenance program drug users. When these two drug-using groups were compared with a control group of pregnant women who delivered within the same Int J Gynecol Obstet 28