ABSTRACT
We present a woman with metabolic disorders secondary to malabsorption and renal disease who gave birth to a stillborn male fetus with left unilateral cleft lip and palate and a live born infant with left unilateral cleft lip and palate. We discuss potential cofactors that could be implicated in the abnormal embryonic process.
Subject(s)
Cleft Lip/etiology , Cleft Palate/etiology , Folic Acid Deficiency/complications , Malabsorption Syndromes/complications , Riboflavin Deficiency/complications , Vitamin A Deficiency/complications , Adult , Female , Humans , Infant , Male , RecurrenceABSTRACT
To determine the perinatal impacts of one abnormal oral glucose tolerance test (GTT) value, we conducted a retrospective study of pregnancy outcome in our population. Pregnant women (4314) were screened for gestational diabetes (GDM) between 24 and 32 weeks with the 50-g glucose challenge test and 183 were directly tested with the 100-g GTT. The subjects who had a serum glucose value equal or greater than 7.8 mmol/L 1 h after a 50-g glucose challenge were scheduled for a 100-g GTT (904). Another 32 subjects, who were not screened, were found to have gestational diabetes identified by repeated fasting and postprandial serum glucose measurements. Retrospectively, the study population was divided in four groups: I, normal (4138); II, GDM (237); III, subjects with one abnormal GTT value treated like GDM (85); IV, subjects with one abnormal GTT value untreated (69). Patient characteristics of groups II, III, and IV were similar. The area under the glycemic curve was similar between groups III and IV and was statistically inferior to that of Group II. GTT periodicity was the greatest in group II. Group II showed a higher rate of delivery before 37 weeks, of chronic and pregnancy induced hypertension, and of cesarian section but groups III and IV were not statistically different from group I.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Diabetes, Gestational/diagnosis , Glucose Tolerance Test , Pregnancy Outcome , Prenatal Care , Adult , Analysis of Variance , Cesarean Section/statistics & numerical data , Congenital Abnormalities/epidemiology , Female , Fetal Macrosomia/epidemiology , Follow-Up Studies , Humans , Hypertension/epidemiology , Infant, Newborn , Metabolic Diseases/epidemiology , Obstetric Labor, Premature/epidemiology , Obstetric Labor, Premature/etiology , Pregnancy , Pregnancy Complications, Cardiovascular/epidemiology , Respiratory Tract Diseases/epidemiology , Retrospective StudiesSubject(s)
Pregnancy in Diabetics/diagnosis , Female , Humans , Pregnancy , Pregnancy in Diabetics/therapyABSTRACT
A 100-gram oral glucose tolerance test (OGTT) was performed on a selected group of normal women at each trimester of pregnancy to establish reference values for hyperglycemia and hypoglycemia. Ninety three OGTT were performed in the first trimester, 121 in the second trimester, and 98 in the last trimester. The fasting serum glucose did not differ significantly between the trimesters. The values at 60 and 120 minutes were significantly different for the fifth, fiftieth, and ninety-fifth percentiles between each trimester of pregnancy. For the 180-minute readings, the fifth and fiftieth percentiles were not significantly different between the first and second trimester of pregnancy, but the results of the third trimester were significantly higher than those of the other trimesters. The mean fasting insulinemia remained relatively constant during pregnancy. Insulin response to OGTT increased during the progression of the pregnancy. The interpretation of the glucose tolerance tests during pregnancy, either to detect gestational diabetes or hypoglycemia, should take these physiologic changes into account.
