Laparoscopy treatment of adnexal sterility.

A total of 113 patients who were examined and treated for matrimonial infertility underwent surgical laparoscopy at the Sterility and Infertility Department, Clinic of Gynecology and Obstetrics, Clinical Center of Nis. Age distribution in the group of patients who were subjected to surgical laparoscopy after diagnosis was 31.39 +/- 6.1 years, out of whom 74.3% were treated for primary sterility. Out of corrective interventions in laparoscopy, the following procedures were performed: adnexiolysis, salpingo-ovariolysis, fimbrioplasty, terminal salpingoneostomy, cyst puncture and ovarian incision. During any surgical laparoscopy, ovarian biopsy was performed for evaluation of ovarian potency and verification of probable histopathological findings. The most commonly used technique was salpingo-ovariolysis--in 22.88% of cases, followed by fimbrioplasty--18.81%. A total of 42 pregnancies were verified: 36 intrauterine (29 completed at full term) and 6 extrauterine pregnancies. Average conception rate in our patients was 37.17%, while rate of parturition was 25.66%. The rate of pregnancy in different corrective laparoscopic procedures ranged from 18.18%-61.54%. The rate of intrauterine pregnancy was the highest after bilateral fimbrioplasty (47.83%), and the lowest after bilateral neosalpingostomy--9.09%. The rate of delivery after adhesiolysis was 30.8%, after salpingo-ovariolysis--28.8%, after fimbrioplasty--18.3%, and after neostomy--12.5% of the time.

[Placental proteins and protein hormones in high risk pregnancies]. / Proteini i proteinski hormoni placente u visoko rizicnih trudnoca.

Experimental part of this study contains a description of an in vitro pattern of protein and protein hormones synthesis in the placental slices of various gestational ages. Incorporation of leucine -14C into placental proteins in vitro was followed-up for the purpose of measuring intensity of protein biosynthesis during pregnancy. It has been detected that the most intensive biosynthesis occurs in placentas from 6 to 8 weeks of gestation, decreases already in the 12th week, slightly increases from 22 to 24 weeks, and significantly falls at term. The same procedure was applied for the human placental lactogen (HPL) synthesis. HPL synthesis was found to be very intensive in young placentas, low in placentas from 22 to 24 weeks, and again intensive in placentas at term. The author indicates to the presence of certain yet unknown regulatory mechanisms influencing the synthesis. Concentrations of total human chorionic gonadotropins (HCG), HCG beta, HPL and beta1-glycoproteins (SP1) were determined paralelly in placentas of various gestational ages. Clinical and laboratory part of this study is dealing with the significance of dosing HPL, HCG, SP1 and alpha-fetoproteins (AFP) in various high risk pregnancies. The course of pregnancy and the obtained laboratory findings were compared with acid-base states of the newborn infants and with perinatal mortality.

[Antenatal homeostasis of insulin and glucose in the fetus with cytomegalovirus infection]. / Antenatalna homeostaza insulina i glukoze kod fetusa sa citomegalovirusnom infekcijom.

Factors of effect on the fetal glucose level can be of maternal, placental or fetal origin. The level of fetal insulin during gestation is regulated by the potentials of the endogenous fetal production on one hand and on the other by the factors (primarily glucaemia) that stimulate or inhibit its production. The aim of this paper was to analyze in which way and to what extent the congenital infection with the Cytomegalovirus disturbs the metabolism of the fetal glucose and insulin. Umbilical venous cord blood was obtained by cordocentesis at 22 to 29 weeks gestation from 52 women referred to our clinic for fetal karyotyping and scatological analysis of fetal CMV infection. To determine the effect of Cytomegalovirus (CMV) infection on insulin and glucose fetal homeostatis, we performed cordocentesis in 18 patients (group A) with proved congenital CMV fetal infection. Control group (B) consisted of 34 patients in whom blood samples were taken for fetal karyotyping. Maternal and fetal glucose levels were 3.95 mmol/l and 3.15 mmol/l in group A and 4.00 and 3.62 mmol/l in group B, respectively. Maternal average insulin level in group A was 14.45 mU/ml and in fetuses 10.64 mU/ml, while in group B maternal and fetal insulin levels were 12.85 mU/ml and 15.35 mU/ml, respectively. Maternal/fetal (M/F) insulin ratio was in group A 1.35, and in group B 0.84. Statistical analysis showed significantly lower glucose and insulin levels and also higher maternal/fetal insulin ratio in fetuses affected by CMV infection (t = 1.4, p < 0.001). Consequences of congenital CMV infection were fetal hypoglucaemia and hypoinsulinemia.

[Metabolism of amino acids in fetuses with cytomegalovirus infection and growth retardation]. / Metabolizam amino-kiselina kod fetusa sa citomegalovirusnom infekcijom i zastojem u rastu.

Aim of the study was to evaluate correlation between valine and glycine, representatives of essential and nonessential amino acids, in fetuses appropriate and small for gestational age with congenital cytomegalovirus infection. Umbilical venous cord blood was obtained by cordocentesis at 22 to 29 weeks' gestation from 18 women (11 in appropriate for gestational age--A, and seven in small for gestational age--B) fetuses with CMV infection. Plasma amino acids were measured with an Beckman M 121 amino acid analyzer. Maternal valine level was 136.0 mmol/l; fetal valine in AGA and SGA fetuses: 219 and 189 mmol/l respectively. Fetomaternal valine ratio was significantly lower in SGA group (1.39 mmol/l-SGA, 1.61 mmol/l AGA, t = -6.9, p < 0.001). Glycine level in maternal blood was 139.0 mmol/l; fetal in SGA and AGA fetuses 137 mmol/l and 176 mmol/l, respectively. Fetomaternal glycine ratio was also significantly lower in SGA group than in AGA, 1.01 and 1.27 respectively (t = -2.96, p < 0.001). Valine/Glycine maternal and fetal ratio did not show any difference between groups. In congenitally CMV infected fetuses with intrauterine growth retardation there is a decreased valine and glycine level, compared to the congenitally CMV infected fetuses with normal intrauterine growth. There is a lower fetal concentration of these amino acids compared to the maternal level in SGA fetuses. A decreased glycine level compared to the valine level has also been found in congenitally CMV infected fetuses with intrauterine growth retardation.

[125th anniversary of the Serbian Medical Society]. / 125 godina Srpskog lekarskog drustva.

Serbian Medical Society was founded on April 22, 1872. Foundation initiators were physicians of the following nationalities: 5 Serbs, 3 Czechs, 2 Poles, 3 Germans, 1 Slovak and 1 Greek. Josip Pancic was one of its founders as well, and the first president of the Serbian Academy of Sciences and Arts. Dr. Acim Medovic was elected its first President at the Inaugural Assembly, and Dr. Vladan Dordevic its Secretary. Later, on October 17, 1874 Constitution of the Serbian Medical Society was passed and its was acknowledged by the Serbian Interior Minister. The first professional meeting was held on August 5, 1872, when they started the first medical journal named "Serbian Archives for All Physicians" ("Srpski arhiv za celokupno lekarstvo") that is being published regularly even today. At the proposal of SLD a Law on Medical Protection was passed (1881). This Law was translated into two European languages, German and French, and sent to be reconsidered by 400 towns throughout Europe. This Law included, beside the other things, the following: "...penny intended for health cannot be spent either by King, or by the Government or by any political party because it is intended for the health, tratement of the sick and doctors' salaries..." The first Congress of the Serbian physicians and scientists devoted to natural sciences was held in Belgrade from 5th to 7th of September, 1904, and it gahtered about 433 participants, among which over hundred were from abroad. In 1907 SLD organized in Belgrade "The First Scientific Conference of Yugoslav Doctors for Operating Surgery". Red Cross in Serbia was founded upon the initiative of SLD. The first initiative to establish the School of Medicine in Belgrade was given by SLD as well. Members of SLD proved their loyalty and devotion to their people, democracy and liberty during liberation wars in XIX and XX century by putting themselves in service of the sich and wrecked. Today, SLD realizes its professional activity through the work of 76 specialized sections, over 100 branches throughout the Republic of Serbia and the Medical Academy of SLD. Specialized sections publish 11 specialized medical journals. We want to emphasize that the Serbian Medical Society has remained, since its foundation, a non-governmental and apolitical organization.

New technique for artificial lung maturation. Direct intramuscular fetal corticosteroid therapy.

The aim of this study was to present a new technique of administration of antenatal corticosteroid therapy in order to cause fetal lung maturation. A single dexamethasone dose of 4 mg was applied directly to the fetal gluteal musculature by ultrasound-guided intramuscular injection 48 h before delivery. This technique of fetal corticosteroid therapy was applied in six cases. Our patients had high risk pregnancies (preeclampsia diabetes mellitus, intracranial hemorrhage, epilepsy, hyperthyreosis). The pregnancies were terminated in the mother's vital interest. The lecithin/sphyngomyelin (US) ratio was < 1.5:1. There were no procedure-related complications. The fetuses were delivered by cesarean, 48 hours later except for the vaginal delivery in the patient in which fetal death occurred in utero. In five cases an uneventful outcome of fetuses indicated that direct fetal corticosteroid treatment improved postnatal lung function in preterm fetuses. A new technique of corticosteroid application successfully prevents respiratory distress in preterm infants decreasing the risk of maternal complications. To our knowledge, this is the first report of fetal intramuscular corticosteroid therapy in the human population.

[125 years' of the Serbian Medical Society]. / Godina 125 Srpskog Lekarskog Drustva.

In the second half of the last century and under the influence of the European civilization, Serbia abandoned the conservative and patriarchal way of life and began to introduce a new, contemporary political, cultural and social spirit into the country. The development of these civilizing features was under the influence of young intelectuals who, as former scholarship holders of the Serbian government, were educated in many European countries. Among them, there was a group of physicians who returned to the country after having completed their education. They were carriers and holders of the contemporary medical science in Serbia and the neighbouring areas. On April 22, 1872 a group of 15 physicians founded the Serbian Medical Society with the intention to offer an organized medical help and care to the population. The first president was Dr. Acim Medovic and the first secretary Dr. Vladan Dordevic. At the meeting held on May 15, 1872 the text of the Statute of the Society was accepted and immediately submitted for approval to the Ministry of Internal Affairs. In the letter addressed to the minister of internal affairs the following reasons were cited: "... The Belgrade physicians feeling a need for having the main office for their professional and scientific meetings, for which they will find the opportunity and the funds, and in spite of their hard medical labor which requires almost all their time, decided to establish the Serbian Medical Society because they wish to be in trend and follow-up the medical progress and exchange the latest medical information not only among them but also with other graduated doctors living in areas with the Serblan population as well as with all scientists who are willing to contribute to the development of medical science in Serbia...". In the first year of its existence the Serbian Medical Society had 9 regular members, 1 honorary member and 34 corresponding members from Serbia, Slavic and other foreign countries. On August 5, 1872 it was decided to start the publication of a professional journal "Srpski arhiv za celokupno lekarstvo" (Serbian Archives of General Medicine). The journal has still been edited. On suggestion of the Serbian Medical Society the Law of Health Care was promulgated in 1881. It was translated into German and French languages and sent to about 400 addresses in different European countries with the request for their opinion and suggestion. The reply of the Vienna Medical Society was as follows: "... While the Austrians carry out some stupid regulations of health care, at the same time a small Balkan country, Serbia promulgated a Law according to which no one, including the King, the Government or a political party dare not use a cent intended for health service, treatment of the sick people and payment of physicians...". On the occasion of the centenary of the First Serbian insurrection and coronation ceremonies of the King Petar I Karadjordjevic, and under the King's patronage, the First Congress of Serbian physicians and naturalists was organized from 5 to 7 September 1904. There were 433 participants of whom more than 100 foreign participants. A Serbian professor of infectious diseases at the University School of Medicine in Vienna, Dr. Jovan Cokor, presented a paper with results of his studies of tuberculosis according to which tuberculosis could be transmitted from a sick cow to man; in this way he complemented the results and explanations of Dr. Robert Koch who discovered Mycobacterium tuberculosis. In 1907 the Serbian Medical Society organized in Belgrade the First meeting of Yugoslav surgeons. At that time, the foundation of a University school of medicine was planned. The Serbian Red Cross Organization was initiated by the Serbian Medical Society in 1876. On February 2, 1891 a procedure was brought for the establishment of the Medical Chamber. Its activity began in 1901. During the First and Second world wars the activity of the Serbian Medical Society was di

How congenital cytomegalovirus infection changes insulin and glucose homeostasis in affected fetuses.

Factors affecting the fetal glucose level can be of maternal, placental or fetal origin. The level of fetal insulin during gestation is regulated by the potential of the endogenous fetal production on one hand, and on the other, by the factors (primarily glycaemia) that stimulate or inhibit its production. The aim of this paper was to analyze in which way and to what extent congenital infection with the cytomegalovirus disturbs the metabolism of fetal glucose and insulin. Umbilical venous cord blood was obtained by cordocentesis at 22 to 29 weeks gestation from 52 women referred to our clinic for fetal karyotyping and scatological analysis of fetal CMV infection. To determine the effect of cytomegalovirus (CMV) infection on insulin and glucose fetal homeostasis, cordocentesis was performed in 18 patients (group A) with proven congenital CMV fetal infection. The control group (B) consisted of 34 patients in whom blood samples were taken for fetal karyotyping. Maternal and fetal glucose levels were 3.95 mmol/l and 3.15 mmol/l in group A and 4.00 and 3.62 mmol/l in group B, respectively. Maternal average insulin level in group A was 14.45 mU/ml and in fetuses 10.64 mU/ml, while group B maternal and fetal insulin levels were 12.38 mU/ml and 15.35 mU/ml, respectively. Maternal/fetal (M/F) insulin ratio was 1.35 in group A and in group B, 0.84. Statistical analysis showed significantly lower glucose and insulin levels and also a higher maternal/fetal insulin ratio in fetuses affected by CMV infection (t = 1.4 p < 0.001). Consequences of congenital CMV infection were fetal hypoglycaemia and hypoinsulinemia.

Essential and nonessential amino acids in appropriate and small for gestational age fetuses with congenital cytomegalovirus infection.

The aim of the study was to evaluate the correlation between valine and glycine, representatives of essential and nonessential amino acids, in appropriate and small fetuses for gestational age with congenital cytomegalovirus (CMV) infection. Umbilical venous cord blood was obtained by cordocentesis at 22 to 29 weeks' gestation from 18 women (11 in appropriate for gestational age (AGA) -A, and 7 in small for gestational age (SGA) -B) fetuses with CMV infection. Plasma amino acids were measured with a Beckman M 121 amino acid analyzer. Maternal valine level was 136.0 mmol/l; fetal valine in AGA and SGA fetuses: 219 and 189 mmol/l, respectively. Fetomaternal valine ratio was significantly lower in the SGA group (1.39 mmol/l-SGA, 1.61 mmol/l AGA, t = 6.9 p < 0.001). The glycine level in maternal blood was 139.0 mmol/l; fetal in SGA and AGA fetuses 137 mmol/l, and 176 mmol/l, respectively. The fetomaternal glycine ratio was also significantly lower in the SGA group than in AGA. 1.01 and 1.27, respectively (t = -2.96, p < 0.001). Valine/glycine maternal and fetal ratio did not show any difference between groups. In the congenital CMV infected fetuses with intrauterine growth retardation there were decreased valine and glycine levels compared to the congenitally CMV infected fetuses with normal intrauterine growth. There was a lower fetal concentration of these amino acids compared to the maternal level in SGA fetuses. A decreased glycine level compared to the valine level has also been found in congenitally CMV infected fetuses with intrauterine growth retardation.

[Effect of organic solvents on gynaecological diseases]. / Uticaj organskih rastvaraca na pojavu ginekoloskih oboljenja.

The authors studied the effect of working conditions and harmful organic solvents on the frequency of gynaecological diseases and menstrual disorders in 138 women. The experimental group consisted of 88 women exposed to evaporation and increased concentrations of organic solvents, and the control group was composed of 50 employees without any harmful effect of these noxa. It was found that adnexitis and dysmenorrhea were more frequent in the experimental group than in the control group, and that the statistical difference was significant (p<0.01). However, the frequency of gynaecological diseases, such as haemorrhages and menstrual disorders, were almost the same in both groups, without a statistically significant difference (p>0.05).

[Effect of heavy metals on symptoms of high-risk pregnancy]. / Uticaj teskih metala na pojavu visokorizicnih trudnoca.

The authors studied the effect of working conditions and harmful organic solvents on the frequency of gynaecological diseases and menstrual disorders in 138 women. The experimental group consisted of 88 women exposed to evaporation and increased concentrations of organic solvents, and the control group was composed of 50 employees without any harmful effect of these noxa. It was found that adnexitis and dysmenorrhea were more frequent in the experimental group than in the control group, and that the statistical difference was significant (p<0.05). However, the frequency of gynaecological diseases, such as haemorrhages and menstrual disorders, were almost the same in both groups, without a statistically significant difference (p>0.05).

The role of beta-endorphin in pregnancy and delivery.

This paper deals with beta-endorphin determination in 20 autopsy specimens of human fetal and neonatal pancreas, as well as in the placental tissue specimens of the same fetoplacental units, by means of radioimmunoassay (RIA-Nichols Institute). Peripheral blood samples of 10 healthy non-gravids were taken as controls. Our results present a marked increase of beta-endorphin levels with the progression of gestation, reaching a peak of 3960 pg/g at term. The data obtained indicate that beta-endorphin plays an important role in pregnancy and delivery regulation.

[The cult of breast feeding in Serbian medical, sacral and folk historiography]. / Kult podoja kod Srba u medicinskoj, sakralnoj i narodnoj istoriografiji.

The World Week on Nursing, as the most natural infant feeding, was organised in Belgrade in 1994. Nourishment at the breast has been known from time immemorial. The cult of nursing in Serbian medical, religous and traditional culture is great. The role of breast-feeding was emphasized in the ancient Serbian medical literature and many textbooks as well as by many physicians during their lectures and talks. There are also two fresco-paintings with the presentation of a mother nursing her baby, of which one has been used as a motive on a UNICEF postage stamp in 1992.

Ceftriaxone in prevention of complications after cesarean section and its influence on the newborn.

The study included 303 patients subjected to elective cesarean section. Thirty two (11%) patients were classified in group A (with prophylactic ceftriaxone administration), 28 (87.5%) of whom had uneventful postoperative courses and 4 (12.5%) who had complications. Group B (with therapeutical application of ceftriaxone) was composed of 135 (45%) patents, 127 (94.1%) with uneventful postoperative courses and 8 (5.9%) with complications. Group C (in whom other antibiotics were used) consisted of 95 (31%) patients, 72 (75.8%) with uneventful postoperative courses and 23 (24.2%) with complications. Group D (no antibiotics used) was composed of 41 (13%) patients, 31 (75.6%) with uneventful postoperative courses and 10 (24.4%) with complications. Statistical analysis revealed highly significant differences in distribution of complications according to whether any, and which one of the antibiotics was used (X2 = 17.81, p < 0.005). This difference mainly resulted from lower incidence of complications associated with ceftriaxone use than in patients with no antibiotic therapy (X2 = 11.66; p < 0.005) as well as in patients using other antibiotics (X2 = 15.95; p < 0.005). Significant difference was also noted when patients given antibiotics other than ceftriaxone were compared with patients receiving no antibiotics other than ceftriaxone were compared with patients receiving no antibiotic therapy (X2 = 4.45; p < 0.05). Group A of newborns included 17 (89.5%) with high Apgar score, while 2 children (10.5%) had the score below 8. Group B had 2 children (11.7%) with Apgar score below 8, while 15 (88.3%) children had higher scores.(ABSTRACT TRUNCATED AT 250 WORDS)

Is there a link between beta-endorphin and diabetes in pregnancy?

The possible influence of both beta-endorphin and insulin secretion on diabetes development in pregnant women was studied by means of radioimmunoassay technique (RIA-Nichols Institute). The study was carried out by determination of beta endorphins in peripheral blood samples of 28 pregnant women with gestational diabetes. They consisted of two subgroups: 14 women with insulin independence, and 14 with insulin-dependent disease. Beta endorphin increase was found in both groups, according to the progression of gestation, and the rise was significantly higher in the insulin-dependent group. At the same time, insulin application caused a marked growth of beta-endorphins in insulin-dependent group. Beta-endorphins, inhibiting insulin secretion, can influence gestational diabetes development.

A comparison of cytology and cervicography in cervical screening.

The sensitivity and specificity of cervical cytology and of cervicography in the detection of CIN and invasive cancer of the cervix were determined in a screening programme of an asymptomatic population of 418 women. Because all of the subjects were examined colposcopically and biopsies were taken from any suspicious areas, the presence or absence of disease was determined by the histology of directed cervical biopsies independently of the screening methods being tested. Cervicography correctly identified 24 of the 27 women with CIN or invasive cancer, whereas cytology detected only 14 (sensitivity of 0.89 vs. 0.52; P < 0.01). Cervicography detected CIN in 11 women with negative smears, six having CIN III. Only one case of CIN I was detected by cytology when cervicography was negative. Two cases of CIN II were not detected by either method. Inclusion in the analysis of the results from 23 women with technically defective cervigrams reduced the size of the difference in sensitivity, but it remained significant (0.74 vs. 0.48; P < 0.05). Cervicography was only slightly less specific than cytology (0.92 vs. 0.94; NS). Cervicography appears to be more effective than cytology in screening for cervical premalignancy but may be more demanding of those who perform the test.

[The course and outcome of pregnancy in pregnant women with hypothyroidism]. / Tok i ishod trudnoce kod trudnica s hipotireozom.

The report presents the analysis of 56 pregnant women with hypothyroidism as a consequence of different aetiopathogenetic factor, and 20 healthy pregnant women with normal pregnancies and term deliveries. Patients with hypothyroidism diagnosed prior pregnancy (46) were treated before and during pregnancy with thyroid hormone preparations. Patients with hypothyroidism verified in subclinical form during pregnancy (10) were not treated. In all examined pregnant women the mean values with standard deviations for thyroid-stimulating form hormone levels, total thyroxine and triiodothyronine, in each trimester of pregnancy, free thyroxine and triiodothyronine in the first and the last trimester were recorded; dynamics of their trends, as well as correlation of values in healthy pregnant women were presented. The analysis of the pregnancy course revealed a significantly higher incidence of gestational diabetes mellitus and preeclampsia (p < 0.001). It may be suggested that hypothyroidism is one of the risk factors for development of gestational diabetes, and also one of the pre-existing factors for development of preeclampsia. Delivery occurred in 83.9% of patients; in 12.8% of patients delivery was prior to term while spontaneous abortion occurred in 16.1% of cases (in one third in the first trimester). Similar results were observed in pregnant women with subclinical hypothyroidism. There were 4.2% of stillbirths which corresponded to the rate of perinatal mortality. One infant was born with hydrocephalus and the others were healthy. In the authors' opinion it is necessary to achieve normal metabolic state before pregnancy which should be maintained with substitutional therapy during the whole pregnancy.

[The effect of pre-eclampsia on thyroid gland function]. / Uticaj preeklampsije na funkciju tireoidne zlezde.

The prospective study involved 183 pregnant women with disorders of the thyroid gland, who were regularly followed up and delivered at the Department of Gynaecology and Obstetrics, University Clinical Centre, Belgrade, over a period of 10 years (1981-1990). There were 15 euthyroid patients in whom development of pre-eclampsia was diagnosed in the last trimester of pregnancy, and 20 healthy pregnant women with normal pregnancies and termed deliveries. The incidence of pre-eclampsia was analyzed depending on the basic disease, therapy and pregnancy metabolic status, as well as on their influence on the function. A statistically significant higher incidence of pre-eclampsia (p < 0.001) was observed in pregnant women with hyperthyroidism (26.0%) and hypothyroidism (26.8%). On the other hand, in euthyroid patients with pre-eclampsia the authors found that the concentration of total and free thyroxine was somewhat lower, while that of thyroid-stimulating hormone was a little higher comparing to the healthy pregnant women in the last trimester of pregnancy. Similar changes were noticed in patients with hypothyroidism. In pregnant women with hyperthyroidism and pre-eclampsia it was established that the concentration of thyroxine and triiodothyronine was somewhat higher, and that concentration of thyroid-stimulating hormone was a little lower comparing to all examined women in the equal metabolic condition. In the authors' opinion diseases of the thyroid gland represent a predisposing factor, i.e. a risk factor for the development of pre-eclampsia. The aim of further investigation is to observe mutual influences, pathogenetic mechanisms of further development of pre-eclampsia in patients with thyroid disorders, i. e. the influence of pre-eclampsia on thyroid disorders.

The estimation of fructosamine and HbAlc in pregnant women with diabetes mellitus.

Fructosamine, HbAlc, glucose, albumins and total proteins were estimated in 40 healthy pregnant women and 80 pregnant women with insulin dependent diabetes mellitus. Fructosamine was estimated by the NBT method with "Fructosamine test" commercially available kit on Technicom automatic analyser RA-1000. Glucose was determined on Beckman glucose analyser. HbAlc was assayed by the Bio-Rad test, while albumin and total proteins by Beckman tests. For all estimated parameters no significant differences were found between healthy pregnant women and pregnant women with insulin dependent diabetes mellitus.