Diabetes mellitus with pregnancy Al-Zahraa experience

Eighty pregnant diabetic patients were included in this study. Patients were classified acording to Whites classification and gestational age on admission. Home and hospital management with or without insulin were resorted to, to maintain euglycemia. Maternal and foetal outcome were studied. The effect of parity and time of booking as well as class of diabetes and success of control are presented. Incriminating history was found in 75% of cases. Most obstetric complications occurred in class B diabetes especially in those coming after the 2[nd] trimester. Maternal and perinatal mortality and morbidity were reduced to levels comparable to international standards

Evaluation of the optical density determination of the amniotic fluid in assessing fetal lung maturity

Respiratory distress syndrome [R.D.S.] is the commonest respiratory disorder in the premature infant which accounts for a high incidence of neonatal death. R.D.S. is due to a deficiency of surface active material [surfactant] in the neonatal lung. This surfactant was only reliably assessed by measuring the Lecithin/sphingomyelin ratio [L/S] in the amniotic fluid. Amniotic fluid optical density [O.D.] at 650 nm was reported to be as reliable as L/S in assessing fetal Lung maturity. Fifteen pregnant women of the high risk group between 28 and 34 weeks were studied. L/S ratio and optical density at 650 nm of the amniotic fluid were estimated on all patients before and 48 hrs after 4 intra-muscular injections of betamethazone [6 mg every 12 hrs]. Six patients were delivered within 2 -6 days after the injection, one baby died of R.D.S. and the others survived. The remaining 9 patients passed safely through their pregnancies and delivered at term. Amniotic fluids with O.D. at 650 nm of 0.15 were found to have an L/S ratio over 2 while readings <0.05 corresponded to L/S ratio of about 1.3 and readings between 0.05 and 0.15 corresponded to L/S ration of 1.5. Betamethazone injections raised the O.D. [as well as the L/S ratio] from immature pre treatment values to mature post treatment values in 12 out of the 15 cases studied. O.D. readings at 650 nm is a simple, easy, fast and as reliable as the L/S ratio in deciding fetal lung maturity