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1.
Vet Pathol ; 54(1): 178-187, 2017 01.
Article in English | MEDLINE | ID: mdl-27507806

ABSTRACT

Spontaneous age-related lesions of laboratory rabbits are not well documented in the contemporary scientific literature. A retrospective study of diagnostic necropsies of 36 rabbits >2 years of age found a number of common lung lesions. Fibromuscular intimal hyperplasia affected medium and to a lesser extent large pulmonary arteries and was present to a variable extent in all 36 rabbits >2 years of age. The lesions were characterized by fragmentation and/or reduplication of the internal elastic lamina (IEL), proliferation of smoothelin+/alpha-smooth muscle actin (α-SMA)+/vimentin- smooth muscle cells and fewer smoothelin-/α-SMA+/vimentin+ myofibroblasts, and intimal deposition of collagen without thrombosis, embolism, or evidence of pulmonary hypertension. Pulmonary emphysema, present in 30/36 rabbits, was characterized by the loss of alveolar septa; most affected rabbits did not have clinical signs of respiratory disease. In 8/13 rabbits of the inbred EIII/JC audiogenic strain, we identified a unique syndrome of granulomatous pneumonia containing hyaline brown to gray, globular to ring-like acellular material that was Alcian blue and periodic acid-Schiff positive. The material was immunoreactive for surfactant protein-A and had the ultrastructural appearance of multilamellar vesicles, suggesting a genetic defect in surfactant metabolism. Additionally, we found small benign primary lung tumors (fibropapillomas, 5 rabbits) not previously described. Other findings included heterotopic bone (5 rabbits), subacute to chronic suppurative bronchopneumonia, pyogranulomatous pneumonia with plant material, and pulmonary artifacts from barbiturate euthanasia solution.


Subject(s)
Lung/pathology , Rabbits/physiology , Aging/pathology , Animals , Female , Male , Pneumonia/pathology , Pneumonia/veterinary , Pulmonary Artery/pathology , Rabbits/anatomy & histology , Retrospective Studies
2.
Vet Pathol ; 53(2): 456-67, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26936752

ABSTRACT

Inbred mice are a unique model system for studying aging because of the genetic homogeneity within inbred strains, the short life span of mice relative to humans, and the rich array of analytic tools that are available. A large-scale aging study was conducted on 28 inbred strains representing great genetic diversity to determine, via histopathology, the type and diversity of spontaneous diseases that aging mice develop. A total of 20 885 different diagnoses were made, with an average of 12 diagnoses per mouse in the study. Eighteen inbred strains have had their genomes sequenced, and many others have been partially sequenced to provide large repositories of data on genetic variation among the strains. This vast amount of genomic information can be utilized in genome-wide association studies to find candidate genes that are involved in the pathogenesis of spontaneous diseases. As an illustration, this article presents a genome-wide association study of the genetic associations of age-related intestinal amyloidosis, which implicated 3 candidate genes: translocating chain-associated membrane protein 1 (Tram1); splicing factor 3b, subunit 5 (Sf3b5); and syntaxin 11 (Stx11). Representative photomicrographs are available on the Mouse Tumor Biology Database and Pathbase to serve as a reference when evaluating inbred mice used in other genetic or experimental studies to rule out strain background lesions. Many of the age-related mouse diseases are similar, if not identical, to human diseases; therefore, the genetic discoveries have direct translational benefit.


Subject(s)
Aging/genetics , Amyloidosis/genetics , Genetic Variation , Genome-Wide Association Study/methods , Genome/genetics , Mice, Inbred Strains , Animals , Cause of Death , Cohort Studies , Cross-Sectional Studies , Disease Models, Animal , Female , Longitudinal Studies , Male , Mice , Mice, Inbred Strains/genetics , Phenotype , Sequence Analysis, DNA
3.
Vet Pathol ; 53(2): 504-9, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26169384

ABSTRACT

Endocardiosis or myxomatous degeneration of the cardiac valves is a well-described age-related change in humans and dogs. Lesions consist of polypoid nodular proliferations of loose extracellular matrix and valvular interstitial cells, most commonly affecting the mitral valve. This entity has not been previously described in fish. Herein we report the appearance, location, and occurrence of valvular and mural endocardiosis in a retrospective survey of aging laboratory zebrafish. Endocardiosis was present in 59 of 777 fish (7.59%), most commonly affecting the sinoatrial (34 fish; 57.6%) and atrioventricular (33 fish; 55.9%) valves. Lesions were more common in fish raised in recirculating water systems and fed commercial diets (52/230 fish; 22.6%) versus flow-through systems with fish fed semi-purified diets (4/234; 1.71%). Lesions were overrepresented in fish heterozygous for a mutant smoothened allele (34/61 fish, 55.7% vs 17/168, 10.1% wild type). There was no association between endocardiosis and intestinal carcinoids. Valvular endocardiosis is a significant age- and husbandry-related background finding in zebrafish and should be considered in the design and interpretation of research studies.


Subject(s)
Aging/pathology , Endocarditis/veterinary , Fish Diseases/pathology , Zebrafish , Animals , Disease Models, Animal , Endocarditis/pathology , Extracellular Matrix/pathology , Female , Male , Mitral Valve/pathology , Retrospective Studies
4.
Vet Pathol ; 52(4): 757-9, 2015 Jul.
Article in English | MEDLINE | ID: mdl-25281653

ABSTRACT

Seven male Hartley guinea pigs, 3 to 18 months old, died or had to be euthanized because of nonspecific clinical signs unresponsive to supportive treatment. Gross necropsy and histopathology findings in all animals included severe soft tissue calcification affecting the myocardium, kidneys, and occasionally the liver.


Subject(s)
Calcinosis/veterinary , Heart Failure/veterinary , Animals , Calcinosis/pathology , Diagnosis, Differential , Guinea Pigs , Heart Failure/pathology , Male , Myocardium/pathology
5.
Vet Pathol ; 52(2): 388-92, 2015 Mar.
Article in English | MEDLINE | ID: mdl-24913269

ABSTRACT

Chordomas are uncommon neoplasms arising from notochord remnants, most commonly occurring in the axial skeleton. Extraskeletal soft tissue chordomas are rare primary tumors, and primary alimentary tract chordomas have not been reported. Herein we report 24 cases of spontaneous primary intestinal chordomas in zebrafish, as well as 9 spontaneous vertebral chordomas. Both intestinal and vertebral tumors showed invasive behavior, although more commonly in the latter. In all cases of primary intestinal chordomas, there was no axial or peripheral skeletal or other nonvisceral involvement. Although uncommon, intestinal chordomas represent a unique background lesion in aged zebrafish.


Subject(s)
Chordoma/veterinary , Fish Diseases/pathology , Intestinal Neoplasms/veterinary , Spinal Neoplasms/veterinary , Animals , Chordoma/pathology , Female , Intestinal Neoplasms/pathology , Male , Spinal Neoplasms/pathology , Zebrafish
6.
Vet Pathol ; 51(3): 659-62, 2014 May.
Article in English | MEDLINE | ID: mdl-23912713

ABSTRACT

A 1.4-year-old virgin female brown-hooded fancy rat presented for abdominal distention, jaundice, and dyspnea. At physical examination, a firm mass was palpable in the caudoventral abdomen as well as multiple small nodular masses associated with the abdominal viscera. At necropsy, in addition to a large mass replacing the left ovary and myriad nodules studding the peritoneal surface, there was 31 ml of abdominal effusion. By cytology, the abdominal fluid contained numerous pleomorphic vacuolated tumor cells surrounding globular pale eosinophilic to amphophilic acellular material that was strongly periodic acid-Schiff positive. Histologically, the tumor was biphasic with abundant acellular hyaline matrix that was also periodic acid-Schiff positive.


Subject(s)
Animals, Laboratory , Endodermal Sinus Tumor/veterinary , Ovarian Neoplasms/veterinary , Rodent Diseases/diagnosis , Rodent Diseases/pathology , Animals , Ascites/pathology , Ascites/veterinary , Cytological Techniques/veterinary , Diagnosis, Differential , Dyspnea/pathology , Dyspnea/veterinary , Endodermal Sinus Tumor/diagnosis , Endodermal Sinus Tumor/pathology , Fatal Outcome , Female , Ovarian Neoplasms/diagnosis , Ovarian Neoplasms/pathology , Rats , Viscera/pathology
7.
J Appl Physiol (1985) ; 115(4): 546-55, 2013 Aug 15.
Article in English | MEDLINE | ID: mdl-23743403

ABSTRACT

Lung deposition of >0.5-µm particles is strongly influenced by gravitational sedimentation, with deposition being reduced in microgravity (µG) compared with normal gravity (1G). Gravity not only affects total deposition, but may also alter regional deposition. Using gamma scintigraphy, we measured the distribution of regional deposition and retention of radiolabeled particles ((99m)Tc-labeled sulfur colloid, 5-µm diameter) in five healthy volunteers. Particles were inhaled in a controlled fashion (0.5 l/s, 15 breaths/min) during multiple periods of µG aboard the National Aeronautics and Space Administration Microgravity Research Aircraft and in 1G. In both cases, deposition scans were obtained immediately postinhalation and at 1 h 30 min, 4 h, and 22 h postinhalation. Regional deposition was characterized by the central-to-peripheral ratio and by the skew of the distribution of deposited particles on scans acquired directly postinhalation. Relative distribution of deposition between the airways and the alveolar region was derived from data acquired at the various time points. Compared with inhalation in 1G, subjects show an increase in central-to-peripheral ratio (P = 0.043), skew (P = 0.043), and tracheobronchial deposition (P < 0.001) when particles were inhaled in µG. The absence of gravity caused fewer particles to deposit in the lung periphery than in the central region where deposition occurred mainly in the airways in µG. Furthermore, the increased skew observed in µG likely illustrates the presence of localized areas of deposition, i.e., "hot spots", resulting from inertial impaction. In conclusion, gravity has a significant effect on deposition patterns of coarse particles, with most of deposition occurring in the alveolar region in 1G but in the large airways in µG.


Subject(s)
Bronchi/physiology , Pulmonary Alveoli/physiology , Administration, Inhalation , Gravitation , Healthy Volunteers , Humans , Particle Size
8.
Vet Pathol ; 49(3): 528-31, 2012 May.
Article in English | MEDLINE | ID: mdl-22262350

ABSTRACT

Seventy-four 9-week old female C57BL/6J mice housed in a conventional facility were manipulated to induce experimental autoimmune encephalomyelitis, among which 26 developed clinical signs including lethargy, absence of defecation, and abdominal distension. By gross necropsy examination, there was distension of the cecum and colon with fecal impaction. By histologic examination, there was severe ulcerative and proliferative typhlocolitis. Fecal ELISA confirmed the presence of toxins A and B of Clostridium difficile. Alteration in immune status of the immunocompetent mice, due to stress caused by experimental manipulation or autoimmune disease, may have led to intestinal dysbiosis, followed by opportunistic infections resulting in C. difficile-associated disease. This report brings to light the occurrence of the disease in immunocompetent laboratory mice during experimental manipulations associated with alteration in immune status, and it discusses potential hazards associated with conventional housing within a hospital-associated research institute.


Subject(s)
Abdomen/pathology , Clostridioides difficile/metabolism , Colitis/veterinary , Constipation/veterinary , Disease Outbreaks/veterinary , Mice, Inbred C57BL , Rodent Diseases/microbiology , Rodent Diseases/pathology , Animals , Bacterial Proteins/metabolism , Bacterial Toxins/metabolism , Colitis/microbiology , Colitis/pathology , Constipation/pathology , Encephalomyelitis, Autoimmune, Experimental/veterinary , Enterotoxins/metabolism , Enzyme-Linked Immunosorbent Assay/veterinary , Female , Housing, Animal , Mice
9.
Vet Pathol ; 47(6): 1028-39, 2010 Nov.
Article in English | MEDLINE | ID: mdl-20587693

ABSTRACT

Vascular Ehlers-Danlos syndrome is a rare genetic disorder resulting from mutations in the α-1 chain of type III collagen (COL3A1) and manifesting as tissue fragility with spontaneous rupture of the bowel, gravid uterus, or large or medium arteries. The heterozygous Col3a1 knockout mouse was investigated as a model for this disease. The collagen content in the abdominal aorta of heterozygotes was reduced, and functional testing revealed diminishing wall strength of the aorta in these mice. Colons were grossly and histologically normal, but reduced strength and increased compliance of the wall were found in heterozygotes via pressure testing. Although mice demonstrated no life-threatening clinical signs or gross lesions of vascular subtype Ehlers-Danlos syndrome type IV, thorough histological examination of the aorta of heterozygous mice revealed the presence of a spectrum of lesions similar to those observed in human patients. Lesions increased in number and severity with age (0/5 [0%] in 2-month-old males vs 9/9 [100%] in 14-month-old males, P < .05) and were more common in male than female mice (23/26 [88.5%] vs 14/30 [46.7%] in 9- to 21-month-old animals, P < .05). Haploinsufficiency for Col3a1 in mice recapitulates features of vascular Ehlers-Danlos syndrome in humans and can be used as an experimental model.


Subject(s)
Collagen Type III/genetics , Disease Models, Animal , Ehlers-Danlos Syndrome/genetics , Haploinsufficiency/genetics , Animals , Aorta/pathology , Arteries/pathology , Blood Vessels/pathology , Blotting, Western , Collagen Type III/metabolism , Colon/pathology , Colon/physiopathology , Ehlers-Danlos Syndrome/pathology , Female , Genotype , Heterozygote , Male , Mice , Mice, Knockout/genetics , Reverse Transcriptase Polymerase Chain Reaction
10.
Vet Pathol ; 43(4): 552-6, 2006 Jul.
Article in English | MEDLINE | ID: mdl-16846999

ABSTRACT

A 10-year-old domestic shorthair cat was spayed to remove bilateral ovarian masses and an enlarged uterus. Both ovaries were effaced by large, irregular, firm, glistening, white cystic masses filled with clear viscous fluid. The uterine lumen was filled with copious amounts of clear viscous fluid, and the uterus contained multiple, firm, glistening, white nodules. Histologic examination revealed an invasive spindle cell neoplasm with features of malignancy, and extensive hypocellular areas containing an alcian blue-positive myxoid matrix. Tumor cells expressed caldesmon, alpha-smooth muscle actin, and estrogen receptor but were negative for desmin. The animal was euthanized 1 month later because of suspected local tumor recurrence. At necropsy, the abdominal cavity contained 120 ml of mucoid ascites; multiple tumor nodules were present in the abdominal and thoracic cavities. The clinical behavior and gross, microscopic, and immunohistochemical findings established a diagnosis of myxoid leiomyosarcoma.


Subject(s)
Cat Diseases/pathology , Leiomyosarcoma/veterinary , Uterine Neoplasms/veterinary , Animals , Cat Diseases/surgery , Cats , Female , Hysterectomy/veterinary , Immunohistochemistry/veterinary , Leiomyosarcoma/secondary , Neoplasm Metastasis , Neoplasm Recurrence, Local/veterinary , Uterine Neoplasms/pathology , Uterine Neoplasms/surgery
11.
Vet Pathol ; 43(3): 377-80, 2006 May.
Article in English | MEDLINE | ID: mdl-16672589

ABSTRACT

Deciduosarcoma is a rare, hormonally dependent neoplasm with features of malignancy, previously reported only in rabbits enrolled in chronic toxicology studies involving estrogens with or without progestins. An exploratory laparotomy was performed on a 6-year-old pet Dutch dwarf rabbit following palpation of a 6-cm-diameter abdominal mass. Grossly, the mass was fleshy and nodular, adhered to but not appearing to originate from the small intestine, with a smaller mass of similar appearance involving the uterus, and an effaced mesenteric lymph node. Histologically, the mass was characterized by spindloid cells and large epithelioid cells with abundant pale eosinophilic vacuolated cytoplasm and an infiltrative pattern of growth. Giant cells with large, bizarre, hyperchromatic nuclei were common. Cells were positive by immunohistochemistry for vimentin and progesterone and estrogen receptors and negative for pancytokeratin (AE1/AE3), cytokeratin 18, desmin, alpha-smooth muscle actin (SMA), and CD10. Based on histologic and immunohistochemical findings, a diagnosis of deciduosarcoma was made.


Subject(s)
Animal Diseases/diagnosis , Deciduoma/pathology , Rabbits , Sarcoma/veterinary , Uterine Neoplasms/veterinary , Animal Diseases/pathology , Animals , Female , Sarcoma/diagnosis , Sarcoma/pathology , Uterine Neoplasms/diagnosis , Uterine Neoplasms/pathology
12.
J Wildl Dis ; 42(4): 788-96, 2006 Oct.
Article in English | MEDLINE | ID: mdl-17255445

ABSTRACT

Eimerioriniid coccidia commonly infect vertebrates and might contribute to morbidity and mortality under captive conditions. The common genus Eimeria typically shows tissue specificity, usually being limited to the epithelium of the gut; disseminated infections are rare in vertebrates. Disseminated visceral coccidiosis was found in two wild-caught adult female Indo-gangetic flap-shelled turtles (Lissemys punctata andersonii) that died while in captivity at a zoo. Sporulated oocysts of Eimeria spp. were found in lung and liver of one turtle and in auditory canal, nasal mucosa, pharynx, lung, liver, kidney, spleen, and intestine of the second. Two distinct species of Eimeria were indicated for the latter case by polymerase chain reaction amplification and sequencing of a portion of the 18S rRNA gene; one species was present in nasal mucosa and liver, with a separate species in lung, spleen, and intestine. Severity of inflammation was correlated with coccidial density. Coccidia were in melanomacrophages in liver and spleen; in the interstitium of auditory canal, nasal mucosa, pharynx, lung, and intestine; and within the interstitium and epithelial cells of the renal tubules in kidney. We suggest these disseminated infections might have been facilitated by a compromised immune system.


Subject(s)
Coccidiosis/veterinary , Eimeria/isolation & purification , Turtles/parasitology , Animals , Animals, Wild/parasitology , Coccidiosis/pathology , Eimeria/classification , Fatal Outcome , Female , Organ Specificity , Polymerase Chain Reaction/veterinary
13.
J Comp Pathol ; 133(2-3): 218-22, 2005.
Article in English | MEDLINE | ID: mdl-16026797

ABSTRACT

Epithelioid trophoblastic tumour (ETT), a rare neoplasm of chorionic-type intermediate trophoblastic cells in the human female, was diagnosed in the uterus of a red-tailed guenon, a non-human primate. The animal, having had two live births, had a recent history of heavy vaginal bleeding. Four years after the last known pregnancy, the animal developed a large invasive mass involving the uterus, right ovary and abdominal wall. The tumour was removed surgically, but at necropsy 1.5 years later was found to have a recurrent neoplasm. Histologically, the original mass consisted of nests and cords of mononuclear intermediate trophoblastic cells whose borders were accentuated by intimately associated eosinophilic hyaline extracellular proteinaceous material. Extensive coalescing areas of necrosis with mineralization surrounding islands of viable neoplastic cells created a "geographical" pattern of necrosis. Immunohistochemical examination revealed that neoplastic cells were diffusely strongly positive for cytokeratin 18, and focally positive for human placental lactogen. The histopathological and immunolabelling patterns were consistent with ETT in human beings. This is the first reported case of epithelioid trophoblastic tumour in a non-human species.


Subject(s)
Cercopithecus , Monkey Diseases/pathology , Trophoblastic Neoplasms/veterinary , Uterine Neoplasms/veterinary , Animals , Biomarkers, Tumor/metabolism , DNA, Neoplasm/analysis , Epithelioid Cells/pathology , Fatal Outcome , Female , Immunoenzyme Techniques/veterinary , Monkey Diseases/surgery , Neoplasm Recurrence, Local , Polymerase Chain Reaction/veterinary , Trophoblastic Neoplasms/pathology , Trophoblastic Neoplasms/surgery , Uterine Neoplasms/pathology , Uterine Neoplasms/surgery
14.
J Am Vet Med Assoc ; 215(2): 212-6, 1999 Jul 15.
Article in English | MEDLINE | ID: mdl-10416474

ABSTRACT

OBJECTIVE: To determine whether perioperative antimicrobial prophylaxis would reduce incidence of postoperative infection among dogs undergoing elective orthopedic procedures. DESIGN: Randomized, controlled, blinded, intention clinical trial. ANIMALS: Dogs of any breed, sex, or age undergoing elective orthopedic surgery at a veterinary teaching hospital. PROCEDURES: Dogs were randomly assigned to 1 of 3 groups: treatment with saline solution, treatment with potassium penicillin G, and treatment with cefazolin. Treatments were intended to be administered within 30 minutes prior to surgery; a second dose was administered if surgery lasted > 90 minutes. Dogs were monitored for 10 to 14 days after surgery for evidence of infection. RESULTS: After the first 112 dogs were enrolled in the study, it was found that infection rate for control dogs (5/32 dogs) was significantly higher than the rate for dogs treated with antimicrobials (3/80 dogs). Therefore, no more dogs were enrolled in the study. A total of 126 dogs completed the study. Monte Carlo simulations indicated that compared with dogs that received antimicrobials prophylactically, dogs that received saline solution developed infections significantly more frequently. Difference in efficacy, however, was not observed between the 2 antimicrobial drugs used. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that perioperative antimicrobial prophylaxis decreased postoperative infection rate in dogs undergoing elective orthopedic surgery, compared with infection rate in control dogs. Cefazolin was not more efficacious than potassium penicillin G in these dogs.


Subject(s)
Antibiotic Prophylaxis/veterinary , Cefazolin/therapeutic use , Cephalosporins/therapeutic use , Dog Diseases/prevention & control , Penicillin G/therapeutic use , Penicillins/therapeutic use , Surgical Wound Infection/veterinary , Animals , Bone and Bones/surgery , Dog Diseases/surgery , Dogs , Female , Joints/surgery , Male , Monte Carlo Method , Orthopedics/veterinary , Surgical Wound Infection/prevention & control
15.
J Exp Biol ; 198(Pt 8): 1783-9, 1995 Aug.
Article in English | MEDLINE | ID: mdl-7636447

ABSTRACT

During exercise, pulmonary gas exchange in reptiles was predicted to differ from that in mammals because of their less complex lung structure, which might reduce ventilation-perfusion heterogeneity (V/QL) at the expense of pulmonary diffusion limitation. To investigate this, the multiple inert gas elimination technique was used in six Varanus exanthematicus at rest and during maximal exercise. Trace amounts of six inert gases were infused into the external jugular vein and blood samples were collected from the pulmonary artery and the left atrium. Mixed expired gas samples and ventilatory and metabolic data were acquired. Indices of V/QL heterogeneity, calculated using a 50-compartment model, were low at rest (log standard deviation of perfusion distribution, logSDQ = 0.39) and increased significantly with exercise (logSDQ = 0.78). Oxygen diffusion limitation was apparent during exercise and was comparable to reported mammalian values. A molecular-mass-dependent limitation, suggesting limited intrapulmonary gas mixing, was evident only at rest. An increase in left atrial PO2 from 82mmHg at rest to 96 mmHg during exercise was associated with a corresponding decrease in PCO2. These data indicate adequacy of pulmonary ventilation and gas exchange for metabolic demands in exercising varanid lizards and suggest that less complex lung structures are not necessarily linked to increased pulmonary diffusion limitation.


Subject(s)
Lizards/physiology , Physical Exertion/physiology , Pulmonary Gas Exchange , Respiration , Animals , Carbon Dioxide/blood , Oxygen/blood
17.
Br J Obstet Gynaecol ; 94(10): 957-62, 1987 Oct.
Article in English | MEDLINE | ID: mdl-3689727

ABSTRACT

A retrospective population study in Northern Ireland examined the benefits of centralized care in insulin-dependent diabetic pregnancies. In the 5 years 1979-1983, there were 139, 250 deliveries in Northern Ireland and of these 221 pregnancies occurred in 187 insulin-dependent diabetic patients; 100 were managed entirely in peripheral maternity units, 61 were referred from a peripheral unit to the Royal Maternity Hospital, Belfast and 60 were managed entirely in this central referral hospital. The patients referred from the periphery had the worst past obstetric history with a combined perinatal mortality rate of 200 per 1000. During the study period the perinatal mortality rate was 107 for the referred pregnancies, 33 for those managed entirely in the peripheral units and 18 for those managed at the Royal Maternity Hospital. If those pregnancies terminated for fetal abnormality, and deaths beyond the perinatal period are included, the figures for total fetal loss were 15.5%, 5.5% and 7.1% respectively. Overall the major congenital malformation rate was 7.5%, and for the respective groups 6.5%, 3.0% and 13.0%. For the general population during the same period the perinatal mortality rate was 1.4% and the major congenital malformation rate was 2.5%. Thus it is suggested that only peripheral hospitals which can offer combined antenatal/endocrine care and with a neonatal intensive care unit should undertake the management of the pregnant diabetic.


Subject(s)
Diabetes Mellitus, Type 1/therapy , Hospitals, Maternity/standards , Hospitals, Special/standards , Outcome and Process Assessment, Health Care , Pregnancy Outcome , Pregnancy in Diabetics/therapy , Adult , Female , Fetal Death , Humans , Infant Mortality , Infant, Newborn , Northern Ireland , Obstetrics and Gynecology Department, Hospital/standards , Pregnancy , Referral and Consultation , Retrospective Studies
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