RESUMO
OBJECTIVE: To evaluate the clinical presentation, management, and the outcome of diabetes mellitus in pregnancy. METHODS: One hundred seventy-one patients with diabetes mellitus admitted between September 1, 2006, and June 30, 2008, to the labor room at Maternity Hospital in Kuwait for induction of labor made up the study population; while an equivalent number of patients without medical complications who also were admitted for induction of labor made up the control group. The patients were assessed at admission, and their medical data were extracted. The study and control patients were monitored through labor/puerperium, and the outcome was documented. RESULTS: Gestational diabetes mellitus was diagnosed in 71.9% of the study patients, a past history of diabetes mellitus was recorded in 81.34% of the study patients, and 49.2% of the patients were admitted at 8-12 weeks of gestation for diabetic control. The mean weight gained in pregnancy was significantly higher for control patients (11.52±5.643 versus [vs] 9.90±5.757 kg/m(2); P<0.009), and the body mass index of study patients was higher (32.00±6.160 vs 28.20±5.885 kg/m(2); P<0.0001). Of the study population, 64.3% of the patients were managed with diet and increased physical activity and 35.7% with insulin, diet, and increased physical activity. The incidences of maternal morbidity in both study and control groups were comparable, and the incidence of preeclampsia was low, at 2.3%. The gestational age at delivery was higher in the control group (39.02±1.834 weeks vs 38.62±1.773 weeks; P<0.0001), and the percentage of cesarean deliveries was higher in the study population (44.4% vs 33.3%; P=0.046). The Apgar scores of the both groups were comparable and in the normal range, and the incidences of fetal anomaly (1.17%), shoulder dystocia (1.8%), and Erb's palsy (1.8%) were low. CONCLUSION: Gestational diabetes mellitus was diagnosed in 71.9% of the diabetic patients studied, and dietary control and increased physical activity were the main modalities of management. There was an increased rate of cesarean section in the study population, the incidences of maternal and perinatal morbidity were low, and the perinatal outcomes were satisfactory.
RESUMO
OBJECTIVE: Data on the effect of coconut oil intake on various hematologic and metabolic parameters in pregnant women or animals are scanty. Hence we attempted to assess the effect of oral administration of graded doses of this edible oil during pregnancy, on various hematologic and metabolic parameters in rats. METHODS: Groups of pregnant Sprague Dawley rats were given oral doses of 1 ml, 2 ml, and 4 ml coconut oil twice per day, respectively. Control group of rats were given tap water. Oral feeding of oil was done continuously for a period of 20 days and at the end of the study period the animals were lightly anaesthetized with ether and sacrificed to collect blood samples for analysis. Various hematologic parameters such as red blood cell (RBC) count, white blood cell (WBC) count, hemoglobin (Hg), platelets, lymphocytes, and mean corpuscular hemoglobin concentration (MCHC) were analyzed by a hematology blood analyzer, while metabolic parameters such as cholesterol, triglycerides, urea, uric acid, creatinine, and protein were analyzed by specific analytical kits. Activities of antioxidant enzyme, superoxide dismutase (SOD), glutathione peroxidase (GPX), and total antioxidant activity (TAO) were assessed by specific analytical kits. Statistical analysis of data was performed using a SPSS data analytical package. RESULTS: Oral administration of coconut oil for 20 continuous days of pregnancy did not significantly alter any of the hematologic parameters studied, compared to control group even when the oil was administered at a relatively massive dose of 4 ml/day. Administration of coconut oil appeared to decrease WBC, Hg, platelet, and lymphocyte blood concentrations in treated rats, but the difference, however, was not statistically significant (ANOVA test; p > 0.05). However, platelet concentration was significantly lower (p < 0.05) in rats receiving 1 ml/day of coconut oil compared to control group rats. Administration of coconut oil did not alter the concentrations of protein, cholesterol, urea, triglycerides, uric acid, and creatinine in treated groups of rats significantly (Student's t-test, p > 0.05) compared to those of control rats. SOD, GPX, and TAO levels in control and treated groups were not significantly different (ANOVA test, p > 0.05) than controls. CONCLUSIONS: We conclude that oral administration of coconut oil during pregnancy in rats, even in massive doses, does not cause any significant alterations in hematologic and metabolic parameters. More detailed studies, however, are warranted before extrapolating these results to human situations.
