Risk factors associated with persistence of glucose intolerance one year after gestational diabetes.

One hundred and fourteen women, 89 with previous gestational diabetes and 25 who showed a normal glucose tolerance during pregnancy were retested by OGTT one year postpartum. Gestational diabetics were divided into two groups according to the severity of glucose intolerance. 97.6% of mild gestational diabetics and 79.2% of severe cases returned to normality postpartum. A different behaviour of these groups was shown by comparing OGTT areas before and after delivery. Body Mass Index and the degree of severity of glucose intolerance were shown to be predictive for the persistence of the abnormality postpartum. Follow-up for three to four years was continued in 8 cases of previous severe gestational diabetes. In seven of them a glucose intolerance appeared again during the follow-up after the temporary improvement one year after delivery.

Contribution to the assessment of steroid therapy in the prevention of respiratory distress syndrome in the neonate.

The respiratory distress syndrome (RDS) is a physiological manifestation of neonatal pulmonary immaturity and it is still the major cause of neonatal morbidity and mortality. In order to promote early fetal lung maturity when a preterm delivery is anticipated, a number of pharmacological agents have been investigated. Corticosteroids, in particular, have been extensively used and the results of several trials are reported in literature. A cohort of 246 consecutive singleton preterm infants, liveborn at the Obstetric Clinic of Ferrara University during a 5-year period, was studied to assess whether antenatal steroid therapy reduces the incidence of RDS. Respiratory distress developed in 18.6% of 102 babies who received treatment and in 15.3% of 144 controls, without difference at the statistical analysis. According to previous studies, a lower incidence of RDS was only observed in the treated females compared to non-treated controls (35% vs 46%) at the gestational age of 28-33 weeks. Since the efficacy of steroids seems to be restricted to a very small and specific group of babies, who, moreover are relatively mature by modern intensive care standards, the Authors suggest that the prevention of RDS and its related complications should rely much more on appropriate surveillance and management of the mother and infant than on specific pharmacological interventions.

Glycosylated hemoglobin (HbA1) assay as a test for detection and surveillance of gestational diabetes. A reappraisal.

Total glycosylated hemoglobin (HbA1) levels were measured in 96 gestational diabetics and 139 normal pregnant women in order to assess their usefulness in detection and monitoring of gestational diabetes. Different, although not significant, behaviour of HbA1 values was found in gestational diabetics and controls throughout pregnancy. Significantly higher (p less than 0.005) HbA1 values were found in gestational diabetics between the 24th and the 32nd week of gestation. In spite of this finding a low sensitivity in detecting gestational diabetes was confirmed. HbA1 values and OGTT parameters did not correlate. Delivery of a large-for-date (LGA) baby was not associated with higher HbA1 levels. Overlapping HbA1 levels were found in gestational diabetics and normal pregnant women. This study confirm the low predictive value of HbA1 assay in gestational diabetes.

Advantage of desogestrel containing pill in oral contraception: influence on blood lipids and LCAT activity.

In the present study the effects of a combined oral contraceptive preparation containing 0.150 mg desogestrel and 0.030 mg ethinylestradiol on lipid metabolism were investigated. In particular, we observed significant increase in HDL-cholesterol and apolipoprotein-A-I (apo A-I) and B (apo B). Triglycerides were not significantly modified. The cholesterol esterifying enzyme LCAT, assayed under "maximal" conditions against an exogenous substrate, was significantly decreased despite an increase in the physiological stimulator apo A-I. No changes were observed in the anti-atherogenic indexes apo A-I/apo B and HDL-cholesterol/LDL-cholesterol. Thus, it appears that this combined oral contraceptive has the promising ability to increase the anti-atherogenic HDL-cholesterol particle without altering the atherogenic LDL-cholesterol.

Multiple molecular forms of prolactin during pregnancy in women.

The distribution of isomorphic forms of prolactin in the serum of pregnant women was studied by gel filtration chromatography. Using this technique we were able to resolve three peaks, detected by radioimmunoassay: they were termed 'big-big', 'big' and 'little' prolactin in order of decreasing size, with approximate molecular weights greater than 100 000, 50 000 and 21 000 respectively. They displayed a comparable immunoreactivity to the antiserum employed in the radioimmunoassay, as determined in competition experiments. The relative amount of each hormone form in serum changed during the third trimester of pregnancy. At week 33 of pregnancy, 'little' prolactin accounted for 63.2 +/- 7.7% of the total circulating hormone present in the serum of five normal pregnant women. During the progression of pregnancy, there was a gradual increase in the low molecular weight prolactin, so that, at the time of delivery, the larger forms of the hormone were present only in small amounts.

Sonographic picture of submembranous haematoma.

Two cases of vaginal bleeding during pregnancy where elevation of the membranes was found by means of echography are reported. In one case there was an accessory lobe with a marginal haematoma. No evidence of placenta praevia was found. Elevation of the membranes can represent an echographic sign of submembranous haematoma.

Amniotic fluid beta 2-microglobulin (beta 2-m) as an index of fetal maturity.

Amniotic fluid beta 2 microglobulin (beta 2-m) levels were measured by radioimmunoassay in 78 pregnant women between the 14th and the 42nd week of gestation. 62 were healthy subjects, while eight were affected by EPH gestosis, seven by diabetes (cl. B-F) associated with Rh immunization in one case, one by hydramnios. There was no significant correlation either between beta 2-m and creatinine (n = 18), or between beta 2-m and lecithin sphingomyelin ratio (L/S) (n = 16), although low concentrations of beta 2-m were usually observed after the 35th week of gestation. It is noteworthy that only in one case out of seven with amniotic levels less than 5 microgram/ml L/S ratio was less than 2.