scholarly journals VP37.06: Role of fetomaternal Doppler for the prediction of perinatal outcome in term pregnancies with gestational diabetes

2021 ◽  
Vol 58 (S1) ◽  
pp. 254-254
Author(s):  
O. Graupner ◽  
M. Meister ◽  
C. Franz ◽  
J. Carow ◽  
C. Enzensberger
Keyword(s):  
Gestational Diabetes ◽  
Perinatal Outcome

scholarly journals Correlation of HbA1c levels in late pregnancy with maternal and perinatal outcome in patients with gestational diabetes mellitus

2019 ◽  
Vol 8 (9) ◽  
pp. 3664
Author(s):  
Navjot Kaur ◽  
Poonam Goel ◽  
Reeti Mehra ◽  
Jasbinder Kaur
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Perinatal Outcome ◽  
Late Pregnancy ◽  
Large For Gestational Age ◽  
Third Trimester ◽  
Hba1c Levels

Background: Estimation of HbA1c in gestational diabetes mellitus patients is not being recommended by any societies/guidelines as studies regarding the role of HbA1c for monitoring of euglycemic control and predicting the maternal and perinatal outcomes in GDM patients (unlike overt diabetes) are conflicting and sparse.Methods: This was a prospective study with an aim to evaluate the role of HbA1c estimation in late pregnancy (early and late third trimester) for prediction of pregnancy outcomes in GDM patients. 53 patients with GDM (diagnosed before third trimester) were recruited for the study. HbA1c levels were estimated in late pregnancy (at 28-32 weeks and again repeated at 37 - 39 weeks or at the time of delivery). Correlation of HbA1c levels in third trimester with maternal and perinatal outcome was studied in patients with gestational diabetes mellitus and cut off taken was 5.8%.Results: Of the total 53 patients 54.7% had HbA1c levels <5.8% and 45.3% had HbA1c ≥5.8% done at 28-32 weeks. Also when HbA1c levels done at 37-39 weeks POG/ at the time of delivery, 52.8% patients had <5.8% and 47.2% had HbA1c ≥5.8%. Approximately one-fourth of the patients had HbA1c ≥ 5.8% even with normal blood sugar levels (euglycemic) control. There was statistically significant increased incidence of polyhydramnios, LGA (large for gestational age babies) and increased mean birth weight in patients with HbA1c ≥ 5.8%, done in late pregnancy. However there was no statistically significant difference in the incidence of preterm labour, gestational hypertension or preeclampsia, urinary tract infections, vulvovaginal infections, caesarean deliveries and postpartum haemorrhage in patients with HbA1c ≥5.8% compared to patients with HbA1c <5.8%.Conclusions: The study revealed that in patients of GDM with HbA1c levels ≥5.8% done in third trimester was statistically significantly associated with increased incidence of polyhydramnios, large for gestational age babies and increased mean birth weight when compared to patients with HbA1c <5.8%.

Diet and Nutritional Interventions with the Special Role of Myo-Inositol in Gestational Diabetes Mellitus Management. An Evidence-Based Critical Appraisal

2019 ◽  
Vol 25 (22) ◽  
pp. 2467-2473 ◽  
Author(s):  
Enrique Reyes-Muñoz ◽  
Federica Di Guardo ◽  
Michal Ciebiera ◽  
Ilker Kahramanoglu ◽  
Thozhukat Sathyapalan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Metabolic Diseases ◽  
Nutritional Intervention ◽  
Attractive Alternative ◽  
Special Role ◽  
Dose Frequency ◽  
Nutritional Interventions

Background: Gestational Diabetes Mellitus (GDM), defined as glucose intolerance with onset or first recognition during pregnancy, represents one of the most common maternal-fetal complications during pregnancy and it is associated with poor perinatal outcomes. To date, GDM is a rising condition over the last decades coinciding with the ongoing epidemic of obesity and Type 2 Diabetes Mellitus (T2DM). Objective: The aim of this review is to discuss the role of diet and nutritional interventions in preventing GDM with the explanation of the special role of myo-inositol (MI) in this matter. Methods: We performed an overview of the most recent literature data on the subject with particular attention to the effectiveness of diet and nutritional interventions in the prevention of GDM with the special role of MI. Results: Nutritional intervention and physical activity before and during pregnancy are mandatory in women affected by GDM. Moreover, the availability of insulin-sensitizers such as different forms of inositol has dramatically changed the scenario, allowing the treatment of several metabolic diseases, such as those related to glucose dysbalance. Although the optimal dose, frequency, and form of MI administration need to be further investigated, diet supplementation with MI appears to be an attractive alternative for the GDM prevention as well as for the reduction of GDM-related complications. Conclusion: More studies should be conducted to prove the most effective nutritional intervention in GDM. Regarding the potential effectiveness of MI, further evidence in multicenter, randomized controlled trials is needed to draw firm conclusions.

Study of Possible Relation between Fasting Plasma Glucagon, Gestational Diabetes and Development of Type 2 DM

2020 ◽  
Vol 16 (2) ◽  
pp. 148-155 ◽  
Author(s):  
Ashraf Okba ◽  
Salwa Seddik Hosny ◽  
Alyaa Elsherbeny ◽  
Manal Mohsin Kamal
Keyword(s):  
Gestational Diabetes ◽  
Pregnant Women ◽  
Post Partum ◽  
Plasma Glucagon ◽  
Type 2 Dm ◽  
Fasting Plasma ◽  
Before And After ◽  
Two Phases

Background and Aims: Women who develop GDM (gestational diabetes mellitus) have a relative insulin secretion deficiency, the severity of which may be predictive for later development of diabetes. This study aimed to investigate the role of fasting plasma glucagon in the prediction of later development of diabetes in pregnant women with GDM. Materials and Methods: The study was conducted on 150 pregnant women with GDM after giving informed oral and written consents and being approved by the research ethical committee according to the declaration of Helsinki. The study was conducted in two phases, first phase during pregnancy and the second one was 6 months post-partum, as we measured fasting plasma glucagon before and after delivery together with fasting and 2 hour post-prandial plasma sugar. Results: Our findings suggested that glucagon levels significantly increased after delivery in the majority 14/25 (56%) of GDM women who developed type 2 DM within 6 months after delivery compared to 6/20 (30%) patients with impaired fasting plasma glucose (IFG) and only 22/105 (20%) non DM women, as the median glucagon levels were 80,76, 55, respectively. Also, there was a high statistical difference between fasting plasma glucagon post-delivery among diabetic and non-diabetic women (p ≤ 0.001). These results indicated the useful role of assessing fasting plasma glucagon before and after delivery in patients with GDM to predict the possibility of type 2 DM. Conclusion: There is a relatively high glucagon level in GDM patients, which is a significant pathogenic factor in the incidence of subsequent diabetes in women with a history of GDM. This could be important in the design of follow-up programs for women with previous GDM.

scholarly journals Insights into the role of placenta thickness as a predictive marker of perinatal outcome

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052199096
Author(s):  
Xiwen Sun ◽  
Jiayu Shen ◽  
Liquan Wang
Keyword(s):  
Clinical Practice ◽  
Fetal Growth ◽  
Pregnancy Outcomes ◽  
Perinatal Outcome ◽  
Predictive Marker ◽  
Fetal Abnormalities ◽  
The Relationship

The placenta is a transitory organ indispensable for normal fetal maturation and growth. Recognition of abnormal placental variants is important in clinical practice, and a broader understanding of the significance of placental variants would help clinicians better manage affected pregnancies. Increased thickness of the placenta is reported to be a nonspecific finding but it is associated with many maternal and fetal abnormalities, including preeclampsia and abnormal fetal growth. In this review, we address the questions regarding the characteristics of placenta thickness and the relationship between thickened placenta and poor pregnancy outcomes.

scholarly journals Mediterranean Diet for the Prevention of Gestational Diabetes in the Covid-19 Era: Implications of Il-6 In Diabesity

2021 ◽  
Vol 22 (3) ◽  
pp. 1213
Author(s):  
Anna Lucia Fedullo ◽  
Antonio Schiattarella ◽  
Maddalena Morlando ◽  
Anna Raguzzini ◽  
Elisabetta Toti ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Mediterranean Diet ◽  
Viral Infections ◽  
High Body Mass Index ◽  
Omega 3 ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Gestational Weight ◽  
Poor Outcomes

The aim of this review is to highlight the influence of the Mediterranean Diet (MedDiet) on Gestational Diabetes Mellitus (GDM) and Gestational Weight Gain (GWG) during the COVID-19 pandemic era and the specific role of interleukin (IL)-6 in diabesity. It is known that diabetes, high body mass index, high glycated hemoglobin and raised serum IL-6 levels are predictive of poor outcomes in coronavirus disease 2019 (COVID-19). The immunopathological mechanisms of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection include rising levels of several cytokines and in particular IL-6. The latter is associated with hyperglycemia and insulin resistance and could be useful for predicting the development of GDM. Rich in omega-3 polyunsaturated fatty acids, vitamins, and minerals, MedDiet improves the immune system and could modulate IL-6, C reactive protein and Nuclear Factor (NF)-κB. Moreover, polyphenols could modulate microbiota composition, inhibit the NF-κB pathway, lower IL-6, and upregulate antioxidant enzymes. Finally, adhering to the MedDiet prior to and during pregnancy could have a protective effect, reducing GWG and the risk of GDM, as well as improving the immune response to viral infections such as COVID-19.

scholarly journals Contributing Factors to Perinatal Outcome in Pregnancies with Gestational Diabetes—What Matters Most? A Retrospective Analysis

2021 ◽  
Vol 10 (2) ◽  
pp. 348
Author(s):  
Friederike Weschenfelder ◽  
Friederike Hein ◽  
Thomas Lehmann ◽  
Ekkehard Schleußner ◽  
Tanja Groten
Keyword(s):  
Weight Gain ◽  
Gestational Diabetes ◽  
Perinatal Outcome ◽  
Perinatal Outcomes ◽  
Large For Gestational Age ◽  
Obese Women ◽  
Patient Counseling ◽  
Contributing Factors ◽  
Prepregnancy Bmi ◽  
The Impact

The aim of diabetes care of pregnant women with gestational diabetes mellitus (GDM) is to attain pregnancy outcomes including rates of large-for-gestational-age (LGA) newborns, pre-eclampsia, C-sections (CS) and other neonatal outcomes similar to those of the non-GDM pregnant population. Obesity and excessive weight gain during pregnancy have been shown to also impact perinatal outcome. Since GDM is frequently associated with elevated body mass index (BMI), we evaluated the impact of maternal prepregnancy BMI, development of GDM and gestational weight gain (GWG) during pregnancy on perinatal outcome. We compared 614 GDM patients with 5175 non-diabetic term deliveries who gave birth between 2012 and 2016. Multivariate regression analysis was used to evaluate the independent contribution of each factor on selected perinatal outcome variables. Additionally, subgroup analysis for obese (BMI ≥ 30 kg/m2) and non-obese women (BMI < 30 kg/m2) was performed. LGA was significantly influenced by BMI, GWG and GDM, while Neonatal Intensive Care Unit (NICU) admission was solely impacted by GDM. Maternal outcomes were not dependent on GDM but on GWG and prepregnancy BMI. These results remained significant in the non-obese subgroup only. Thus, GDM still affects perinatal outcomes and requires further improvement in diabetic care and patient counseling.

Role of Colour Doppler in High Risk Pregnancy

2021 ◽  
Vol 6 (2) ◽  
pp. 185-191
Author(s):  
Hiral Parekh ◽  
Sneha Chaudhari
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
High Risk Pregnancy ◽  
Colour Doppler ◽  
High Risk Factors ◽  
Risk Pregnancy ◽  
A Prospective Study

This was a prospective study conducted in pregnant patients with high risk factors who got admitted in the Department of Obstetrics and Gynaecology at Care Hospital, Jamnagar during the period from May 2018 to September 2020. Background: High-risk pregnancies causes many adverse perinatal outcomes. Doppler ultrasound is a non-invasive technique to study the feto-maternal circulation to guide the clinical management. Objective: This study aims at evaluating the role of colour Doppler in high-risk pregnancies and their perinatal outcome. Materials and Methods: This was a prospective study carried out for 29 months in the Department of Radiology with antenatal women in the age group of 18-35 years with singleton pregnancy of gestational age of <28 weeks to >35 weeks having high-risk factors considered in study. The risk factors considered were pregnancy induced hypertension (PIH), gestational diabetes, anemia, oligohydramnios, polyhydramnios and IUGR. Doppler study of umbilical artery and fetal middle cerebral artery (MCA) arteries was done and amniotic fluid index (AFI) was measured. Parameters in the form of resistive index, pulsatility index, and systolic/diastolic ratio were taken. obstetric history was taken with regular interval follow up. Results: The study was carried out with 50 patients. High-risk pregnancy was more common in the age group of 21-25 years. The most common high-risk factor in pregnancy was oligohydramnios which accounted for 30% of cases. Out of 50 high-risk pregnancies, 5 (10 %) of cases resulted in intrauterine growth restriction (IUGR). Out of 50 high-risk cases, in 36 cases, umbilical artery findings were abnormal. 3 patients had intrauterine death (IUD) and 27 patients had poor perinatal outcome. Umbilical artery abnormality showed significant sensitivity and negative predictive value for adverse (poor + IUD) perinatal. Correlation was seen between high risk pregnancy and need of emergency caesarean section and induction and associated adverse perinatal outcome. Conclusion: Combination of different arterial waveform study enhance the diagnostic accuracy in identifying those intrauterine growth restricted foetuses that were at risk. Keywords: Colour Doppler, high risk pregnancy, perinatal outcome.

Role of placental fibrinogen-like protein 1 in gestational diabetes

2020 ◽  
Vol 218 ◽  
pp. 73-80
Author(s):  
Lin Kang ◽  
Hung-Yuan Li ◽  
Horng-Yih Ou ◽  
Pensee Wu ◽  
Shu-Huei Wang ◽  
...  
Keyword(s):  
Gestational Diabetes
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