Study on glucose tolerance in pregnancy as a screening test and diagnostic tool for gestational diabetes mellitus

GDM is a common medical problem that results from an increased severity of insulin resistance as well as an impairment of compensatory increase in insulin secretion. GDM is associated with a variety of maternal and fetal complications. Controversy surrounds the ideal approach for detecting GDM, and the approaches recommended for screening and diagnosis are largely based on expert opinion. This study enrolled 51 pregnant women aged between 20 and 39 years old. All women were invited to do fasting and two hours postprandial blood glucose every two weeks, 2 hr. 75g OGTT every trimester. Plasma glucose measurements were performed with glucose oxidase method using semi-automated spectrophotometer [Biosystems 310]. Both normal and GDM cases have normal glucose tolerance in early weeks of pregnancy. However, after 24 weeks of gestation progressive increment of hyperglycemia was obviously observed in GDM cases. Suitable cutoffs in diagnosis of GDM in third trimester are 97 mg/dl for fasting; 174 mg/dl for 1 hour; and 141 mg/dl for 2 hour

Maternal and foetal complications in neglected transverse lie

To see the frequency of foetal and maternal complications of neglected transverse lie at a tertiary care hospital. This prospective study was conducted at Gynae B Unit Department of Gynaecology and Obstetrics Lady Reading Hospital Peshawar, Pakistan, from 1st January I997, to 31st December I997. Eighty-seven Patients presenting with neglected transverse lie were included in this study. Detail information regarding name, age, address, parity, past history, physical, abdominal and vaginal examination findings, general management and specific managements like internal podalic version, caesarean section, foetal complications and maternal complications of neglected transverse lie were entered into a predesigned proforma for the purpose. The maternal complications in order of frequency were dehydration 86.5% [n=77], pyrexia 41.37% [n=36], wound sepsis 31.03% [n=27], antepartum haemorrhage [APH] 16.09% [n=14] and postpartum haemorrhage [PPH] 14.94% [n=13] and maternal death 1.14% [n=1]. The foetal complications of neglected transverse lie were fresh stillbirth 55.17% [n=48], prematurity 14.94% [n=13], alive with poor Apgar score 10.34% [n=9], macerated stillbirth 8.04% [n=7], neonatal death 3.44% [n=3], post mature and alive 2.29% [n=2] and congenital malformation 2.29% [n=2]. Emergency lower segment caesarean section was done in 58 [66.7%] cases, while internal podalic version followed by breech extraction was done in 21 [24.1%] cases. Neglected transverse lie is associated with various maternal and foetal complications. Prenatal examinations are essential to reduce the unfortunate complications of transverse lie

Diagnostic evaluation of [pregnant] patient with acute abdominal pain. The role of imaging modalities

Assess the pregnant patient with other causes of pain not related to pregnancy presenting to emergency department, using different imaging modalities and to review the basic principles of radiation safety. During 18 months, 55 pregnant patients were referred randomly from emergency department for evaluation of abdominal pain prospectively enrolled into our study. Pregnant with pregnancy-related causes such as premature contractions and other related causes were excluded. US evaluation for all patients including a careful search for gall bladder, kidneys, pancreas and appendix related causes. Clinical, surgical, and/or imaging follow-up data were obtained in some patients. Out of 55 patients, 28[50.90%] were confirmed to have an eight with gall-bladder stones [14.54%] five with hydronephrosis related to pregnancy [9.08%], two of renal calculi [3.63%] one had bowel obstruction and pancreatitis [1.81%],seven with pyelonephritis[12.72%], and four with appendicitis [7.27%]. There is an increased incidence of acute abdomen during pregnancy though clinical pictures sometimes get blunted due to gravid uterus. Early diagnosis followed by surgical intervention if needed decrease morbidity for both mother and fetus, also enhances our knowledge of the principles of radiation safety

Prevalence of congenital anomalies in 1000 live births in Javaheri Hospital, Tehran, 2004

Totally, 3-5% of neonates have detectable congenital anomalies. Congenital anomalies are important causes of neonatal morbidity and mortality. With decreasing incidence of fatal infectious diseases, congenital anomalies would be one of the main causes of infants mortality in future. This study has performed to determine the prevalence of congenital anomalies in 1000 live-born neonates at Javaheri Hospital in Tehran during a 6-month period in 2004. For this cross sectional study, 1000 live-born neonates were selected. Neonates with major and minor anomalies were identified by reviewing their medical records. Finally, data analysis was achieved by SPSS software. Congenital anomalies were identified in 52 of 1000 live-born neonates, mostly among male neonates. Undescended testis was by far the most common congenital anomaly. According to the involved system, there was orderly the anomalies of musculoskeletal system, urogenital, cardiovascular, CNS and GI tract. Calcaneovalgus [musculoskeletal anomaly] and undescended testis and hypospadiasis [urogenital anomalies] were found more frequently than others. Some of the congenital anomalies are not recognized at birth and may occur later in life, thus, the aforementioned prevalence rate is underestimated. Attention to preconception care, prenatal care and genetic counseling for high risk parents have important role in prevention of congenital anomalies

Reasons for Zahedan's women for not referring to delivery ward for child delivery

Maternal and infantile mortality are important health indicators of every society due to pregnancy incidents. Maternal and infant mortality and also neonatal tetanus incidents have direct relation with delivery condition. Neonatal tetanus and mortality among mothers and newborns have direct relation with delivery in non-hygienic condition. Non-hygienic delivery rate is very high in Sistan and Baluchestan province. Even in the city of Zahedan with a population of 450000, where as access to maternity hospital is possible for all residents of this city, 50-60% deliveries take place at home. In this study, the reasons of women were investigated for not referring to maternity hospital for delivery. The method of research was case control. Case group was selected from those women whose last deliveries had not taken place in maternity hospital and referred to health centers to vaccinate their children [no. 482]. Control group was selected randomly among women who referred to hospital to give birth [no. 198]. Hospital's high fee [38%], easy delivery at home [19%], fear from cesarean and drugs adverse reaction [13%] were the most prevalent reason for not giving birth at hospital. Employment and literacy rates of those women who had given birth at home were lower than control group. They were mainly from Suni and Baluch ethnic. In order to minimize the cultural barriers of referring to maternal hospital, we advise the respectful officers, to make insurance public, lower the treatments fee, held training programs and provide hygienic conditions with low cost for out of hospital deliveries

Effects of hypertension of pregnant mothers on neonates, Taleghani Hospital- 1999

Recent studies show that presence of hypertension during pregnancy results to neonatal morbidity and mortality. The aim of this study is to investigate and identify the neonatal out comes, which their mothers were afflicted with hypertension during pregnancy. This was a Cohort type of study and in this regard, 160 pregnant women with hypertension were considered from Obs and Gyn Department of Taleghani Hospital, Shahid Beheshti Medical Sciences University. 80 pregnant women without hypertension were considered as control group. Morbidity and mortality were compared in these neonates. Results of this study showed that in group of mothers afflicted with hypertension, morbidity and mortality of neonates were 7.5 times, low apgar scores, 9 times birth of premature neonate, 3.5 times, low birth weight of neonate [fetal growth retardation] 2 times of control group. Since hypertension in pregnant women has many serious side effects for neonates, therefore it is recommended that there should be improved cares during pregnancy and on time of recognition and control of this disease, which can be lead to serious problems, and mortality of neonates