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The reproducibility of the 50-g, 1-h glucose screen for diabetes in pregnancy
Citations from the Literature
one with both activities of sperm immobilization and blocking of sperm-zona tight binding and another with the former activity alone. The vast majority of sperm-immobilizing antibodies reduce zona binding even without the presence of complement.
DISEASES IN PREGNANCY
309
production, and caused a 65 to 80”/”decrease in the urinary excretion of TxAz metabolites, but no decrease in the urinary excretion of PGI, metabolites. Conclusions. ASA did not prevent the rise of maternal hypertension, but improved fetal hemodynamic performance and reduced the need of intensive neonatal care. It inhibited strongly maternal thromboxane A, but not PGIz production and thus shifted the balance between PGIz/TxAz to the dominance of the vasodilatory, antiaggregatory side.
Low dose aspirin in hypertensive pregnant women: Effect on pregnancy outcome and prostacyclin-thromboxane
balance in mother
and newborn
Viinikka L.; Hartikainen-Sorri V.; Ylikorkala 0.;
A.-L.; Lumme R.; Hiilesmaa
FIN
BR. J. OBSTET. GYNAECOL. 1993 100/9 (809-815) Objective. To study the effect of daily treatment with 50 mg of aspirin (ASA) on the hypertensive pregnancy complications and on the production prostacyclin (PGI2) and thromboxane A, (TxAz) in high risk pregnant women and their infants. Design Placebo controlled prospective study. Setting. Departments of Obstetrics and Gynaecology, University of Helsinki, University of Oulu and Central Hospital of Middle Finland, Finland. Subjects. Two hundred and eight pregnant women with pre-existing hypertension or a history of severe preeclampsia in their previous pregnancy. Prostanoids were studied in a subgroup of I8 women. Interventions. The women were randomized to receive ASA (50 mg/day, n = 103) or placebo (n = 105) from the mean of IS weeks gestational age to delivery. The exacerbation of pre-existing hypertension or the appearance of hypertension in previously normotensive women, the appearance of proteinuria and fetal growth were the main end points, but some other clinical characteristics were also recorded. Urinary excretion of PGI, and TxAz metabolites by mothers and infants and their production in umbilical arteries in vitro were also studied. Results. Two women (one in both groups) had miscarriages, and one pregnancy was terminated for fetal anencephaly (ASA group). In addition, seven women discontinued the treatment due to urticaria (two women in ASA group), increased activity of aspartate amino transferase in serum (one woman in both groups), or increased bleeding time (one woman in ASA group, two women in placebo group), and one woman in the placebo group was lost from follow-up. Thus the end points could be assessed in 97 women taking ASA and 100 women taking placebo. ASA did not diminish the rate of the rise of blood pressure without (I2 vs. 14. respectively) or with proteinuria (9 vs. I I). but fetal hemodynamic disturbances as assessed by Doppler equipment (l/44 vs. 6145 women studied, P = 0.05) and need for treatment in neonatal intensive care unit (IO vs. 21, P = 0.04) were more rare in ASA group. ASA tended to increase the birthweight of the newborn (3348 f 707 g vs. 3170 f 665 g, mean f S.D., P = 0.07). but two perinatal deaths occurred in ASA group. ASA prolonged the bleeding time of the mother (435 s. 210-998 s (geometric mean, range) vs. 349 s, 210-690 s, P = 0.02). but caused no extra blood loss during delivery, nor affected neonatal hemostasis. In a subgroup of mothers (ASA, n = IO; placebo, n = 8). ASA inhibited more than 90% of platelet TxA?-
The reproducibility of the SO-g, I-h glucose
screen for diabetes in
Pregnancy Espinosa de 10s Monteros A.; Parra A.; Carino N.: Ramirez A.: MEX
OBSTET. GYNECOL. 1993 82/4 I(515-518) Objective: To explore the day-to-day reproducibility of the 50-g, I-h glucose screening test performed on 2 consecutive days in the same woman. Methods: Eighty women at 12-23.6 weeks’gestation (early subjects) and 80 women at 24-28 weeks (late subjects) without known diabetes mellitus were studied. The glucose screening test was performed in the morning on 2 consecutive days in the same women, under an identical or opposite sequence of fasting and fed conditions. The women were thus divided into four subgroups: fast-fast, fed-fed, fast-fed, and fed-fast. Duplicate serum glucose concentrations were measured by the glucose oxidase method. Paired Student t test was used to analyze day-l vs. day-2 glucose levels in each woman of each subgroup. Results: The serum glucose concentrations were higher on day 1 than on day 2 in the subgroups fast-fast and fast-fed (P < 0.05) in both early and late patients, whereas the opposite was seen in the subgroups fed-fast (P < 0.05). No significant differences were observed in the subgroups of fed-fed. At three different glucose thresholds (130, 135, and 140 mgidL), there was more than 90% daily reproducibility for normal results in both groups, and nearly 50 and 83”/udaily reproducibility for abnormal results in the early and late patients, respectively. Conclusions: Up to 28 weeks of pregnancy, the screening test had a high reproducibility for normal results. For abnormal results, daily reproducibility was better after than before 24 weeks’ gestation, regardless of prior testing conditions. Depending on the pre-testing conditions. the use of a different serum glucose threshold seems warranted. Unrecognized
maternal
peripartum
pertussis with subsequent
fatal neonatal pertussis
Beiter A.; Lewis K.; Pineda E.F.; Cherry J.D.; USA
OBSTET. GYNECOL. 1993 82/4 II SUPPL. (691-693) Background: Pertussis is an illness that is frequently unrecognized in adults. The source of pertussis infection in young infants is usually an adult and most frequently a parent. Case: A woman developed severe paroxysmal coughing requiring hospitalization 6 days before delivery. She was thought to have viral pneumonia and reactive airway disease. One week after birth, her infant developed a similar illness and also required hospitalization. The infant’s respiratory illness progressively worsened. resulting in death. Conclusion: Although the clinical findings were typical for pertussts in both the moth-
Int J Gynecol Ohstet 45
one with both activities of sperm immobilization and blocking of sperm-zona tight binding and another with the former activity alone. The vast majority of sperm-immobilizing antibodies reduce zona binding even without the presence of complement.
DISEASES IN PREGNANCY
309
production, and caused a 65 to 80”/”decrease in the urinary excretion of TxAz metabolites, but no decrease in the urinary excretion of PGI, metabolites. Conclusions. ASA did not prevent the rise of maternal hypertension, but improved fetal hemodynamic performance and reduced the need of intensive neonatal care. It inhibited strongly maternal thromboxane A, but not PGIz production and thus shifted the balance between PGIz/TxAz to the dominance of the vasodilatory, antiaggregatory side.
Low dose aspirin in hypertensive pregnant women: Effect on pregnancy outcome and prostacyclin-thromboxane
balance in mother
and newborn
Viinikka L.; Hartikainen-Sorri V.; Ylikorkala 0.;
A.-L.; Lumme R.; Hiilesmaa
FIN
BR. J. OBSTET. GYNAECOL. 1993 100/9 (809-815) Objective. To study the effect of daily treatment with 50 mg of aspirin (ASA) on the hypertensive pregnancy complications and on the production prostacyclin (PGI2) and thromboxane A, (TxAz) in high risk pregnant women and their infants. Design Placebo controlled prospective study. Setting. Departments of Obstetrics and Gynaecology, University of Helsinki, University of Oulu and Central Hospital of Middle Finland, Finland. Subjects. Two hundred and eight pregnant women with pre-existing hypertension or a history of severe preeclampsia in their previous pregnancy. Prostanoids were studied in a subgroup of I8 women. Interventions. The women were randomized to receive ASA (50 mg/day, n = 103) or placebo (n = 105) from the mean of IS weeks gestational age to delivery. The exacerbation of pre-existing hypertension or the appearance of hypertension in previously normotensive women, the appearance of proteinuria and fetal growth were the main end points, but some other clinical characteristics were also recorded. Urinary excretion of PGI, and TxAz metabolites by mothers and infants and their production in umbilical arteries in vitro were also studied. Results. Two women (one in both groups) had miscarriages, and one pregnancy was terminated for fetal anencephaly (ASA group). In addition, seven women discontinued the treatment due to urticaria (two women in ASA group), increased activity of aspartate amino transferase in serum (one woman in both groups), or increased bleeding time (one woman in ASA group, two women in placebo group), and one woman in the placebo group was lost from follow-up. Thus the end points could be assessed in 97 women taking ASA and 100 women taking placebo. ASA did not diminish the rate of the rise of blood pressure without (I2 vs. 14. respectively) or with proteinuria (9 vs. I I). but fetal hemodynamic disturbances as assessed by Doppler equipment (l/44 vs. 6145 women studied, P = 0.05) and need for treatment in neonatal intensive care unit (IO vs. 21, P = 0.04) were more rare in ASA group. ASA tended to increase the birthweight of the newborn (3348 f 707 g vs. 3170 f 665 g, mean f S.D., P = 0.07). but two perinatal deaths occurred in ASA group. ASA prolonged the bleeding time of the mother (435 s. 210-998 s (geometric mean, range) vs. 349 s, 210-690 s, P = 0.02). but caused no extra blood loss during delivery, nor affected neonatal hemostasis. In a subgroup of mothers (ASA, n = IO; placebo, n = 8). ASA inhibited more than 90% of platelet TxA?-
The reproducibility of the SO-g, I-h glucose
screen for diabetes in
Pregnancy Espinosa de 10s Monteros A.; Parra A.; Carino N.: Ramirez A.: MEX
OBSTET. GYNECOL. 1993 82/4 I(515-518) Objective: To explore the day-to-day reproducibility of the 50-g, I-h glucose screening test performed on 2 consecutive days in the same woman. Methods: Eighty women at 12-23.6 weeks’gestation (early subjects) and 80 women at 24-28 weeks (late subjects) without known diabetes mellitus were studied. The glucose screening test was performed in the morning on 2 consecutive days in the same women, under an identical or opposite sequence of fasting and fed conditions. The women were thus divided into four subgroups: fast-fast, fed-fed, fast-fed, and fed-fast. Duplicate serum glucose concentrations were measured by the glucose oxidase method. Paired Student t test was used to analyze day-l vs. day-2 glucose levels in each woman of each subgroup. Results: The serum glucose concentrations were higher on day 1 than on day 2 in the subgroups fast-fast and fast-fed (P < 0.05) in both early and late patients, whereas the opposite was seen in the subgroups fed-fast (P < 0.05). No significant differences were observed in the subgroups of fed-fed. At three different glucose thresholds (130, 135, and 140 mgidL), there was more than 90% daily reproducibility for normal results in both groups, and nearly 50 and 83”/udaily reproducibility for abnormal results in the early and late patients, respectively. Conclusions: Up to 28 weeks of pregnancy, the screening test had a high reproducibility for normal results. For abnormal results, daily reproducibility was better after than before 24 weeks’ gestation, regardless of prior testing conditions. Depending on the pre-testing conditions. the use of a different serum glucose threshold seems warranted. Unrecognized
maternal
peripartum
pertussis with subsequent
fatal neonatal pertussis
Beiter A.; Lewis K.; Pineda E.F.; Cherry J.D.; USA
OBSTET. GYNECOL. 1993 82/4 II SUPPL. (691-693) Background: Pertussis is an illness that is frequently unrecognized in adults. The source of pertussis infection in young infants is usually an adult and most frequently a parent. Case: A woman developed severe paroxysmal coughing requiring hospitalization 6 days before delivery. She was thought to have viral pneumonia and reactive airway disease. One week after birth, her infant developed a similar illness and also required hospitalization. The infant’s respiratory illness progressively worsened. resulting in death. Conclusion: Although the clinical findings were typical for pertussts in both the moth-
Int J Gynecol Ohstet 45