Platelet Hyperfunction in Infants of Mothers with Diabetes Mellitus (DM)

1979 ◽  
Author(s):  
M.J. Stuart ◽  
H. Elrad ◽  
D.O. Hakanson ◽  
J.E. Graeber ◽  
S. Sunderji ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Platelet Aggregation ◽  
Normal Values ◽  
Diabetic Mother ◽  
Etiologic Factor ◽  
Control Mother ◽  
Normal Platelet ◽  
Neonatal Blood ◽  
Platelet Hyperaggregability ◽  
Diabetic Mothers

Platelet aggregation and prostaglandin formation was evaluated in 20 control mother-neonate pairs (Grp I), and in 13 pairs where maternal DM was present (Grps II and III). Grp I control mothers demonstrated normal platelet aggregation with their infants showing the physiological impairment in aggregation that occurs in the neonate. Using platelet Malonyldialdehyde (MDA) as an indicator of platelet prostaglandin formation, Grp I mothers and infants demonstrated normal values of 3.20 ± 0.31 (1 SD) and 2.46 ± 0.61 n moles MDA per 109 plts respectively. In the 13 patient pairs, 8/13 diabetic mothers (Grp II) showed platelet hyperaggregability and platelet MDA was increased to 3.92 ±; 0.22. All Grp II infants also manifested platelet hyperfunction and increased MDA formation (p<.005) to 3.37 t 0.67.2/8 Grp II neonates restudied on the fourth day of life no longer demonstrated the hyperfunction present at birth. 5/13 diabetic others (Grp III) showed normal platelet aggregation and MDA formation (3.18 ± 0.17) and their infants showed normal neonatal aggregation and MDA formation (2.27 ± 0.67). In tne acuic with DM platelet hyperfunction and increased prostaglandin formation is present, mese findings appear to be transmitted to the offsprings of such mothers as well. Platelet hpperfunction was not correlated with either neonatal blood sugar or blood viscosity measurements. Platelet hyperfunetion may be the etiologic factor in the increased incidence of both arterial and venous thrombosis that occurs in the infant of the diabetic mother.

CLINICAL CONFERENCE

PEDIATRICS ◽  
1961 ◽  
Vol 28 (6) ◽  
pp. 1024-1026 ◽  
Author(s):  
Marvin Cornblath
Keyword(s):  
Diabetes Mellitus ◽  
Neonatal Mortality ◽  
Umbilical Cord ◽  
Congenital Malformations ◽  
Diabetic Mother ◽  
Morbidity And Mortality ◽  
Vernix Caseosa ◽  
Born Infant ◽  
Hands On ◽  
Diabetic Mothers

These infants are remarkable not only because, like foetal versions of Shadrach, Meshach and Abednego, they emerge at least alive from within the fiery metabolic furnace of diabetes mellitus, but because they resemble one another so closely that they might well be related. They are plump, sleek, liberally coated with vernix caseosa, fullfaced and plethoric. The umbilical cord and the placenta share in the gigantism. During their first 24 or more extra-uterine hours they lie on their backs, bloated and flushed, their legs flexed and abducted, their lightly closed hands on each side of the head, the abdomen prominent and their respiration sighing. They convey a distinct impression of having had such a surfeit of both food and fluid pressed upon them by an insistent hostess that they desire only peace so that they may recover from their excesses. And on the second day their resentment of the slightest noise improves the analogy while their trembling anxiety seems to speak of intra-uterine indescretions of which we know nothing. THUS Farquhar described the newly born infant of the diabetic mother. The purpose of this presentation is to review the information that is available concerning such infants and their difficulties. Dekaban and Baird, comparing 235 pregnancies in 48 diabetic mothers with 249 in paired nondiabetic controls, not only reaffirmed the increased intrauterine and neonatal mortality among these infants but also demonstrated an increased morbidity among the survivors. This morbidity included congenital malformations, retardation of development and epilepsy. Despite the increased morbidity and mortality, many of these infants are not sick and do well.

scholarly journals Effects of Insulin treated Established Diabetes Mellitus (EDM) on the Volume of Placental Parenchyma and Weight of the Neonate

1970 ◽  
Vol 7 (1) ◽  
pp. 45-48
Author(s):  
AHMM Mawla Chowdhury ◽  
Selina Anwar ◽  
Meherunnessa Begum ◽  
K Nahid Eva ◽  
Fahmida Shahnaz
Keyword(s):  
Diabetes Mellitus ◽  
Plasma Glucose Level ◽  
Significant Positive Correlation ◽  
Well Being ◽  
Mean Value ◽  
Third Trimester ◽  
Control Mother ◽  
The Mean ◽  
Diabetic Mothers ◽  
Venous Plasma

Taking in mind the effects of diabetes mellitus of varying severity on human placenta and their implication on the well being of the fetus, a quantitative study at the macroscopic level was designed. Sixty post caesarean section human placentas were studied of which thirty were from mothers having insulin treated established diabetes mellitus (EDM) considered as EDM group and thirty were from control mother having no diabetes mellitus. The venous plasma glucose level (fasting and two hours after breakfast) of the diabetic mothers in second and third trimester were recorded and the mean of the values were calculated. The value ranged from 5.93 to 10.10 and the mean was 7.28±0.90. The two groups did not differ significantly from each other with age, weight, height, or parity of the mother or in gestational age. Parenchymal volume in control and EDM group were 300.14±75.43 and 309.25±61.64 respectively. The value showed higher mean value in EDM group. The differences did not reach a significant level. The neonatal weight in control and EDM group were 2.95±0.53 and 3.05±0.52 respectively. The neonate did show a tendency towards being heavier in EDM group, but no reached the significant level. There was a significant positive correlation between the neonatal weight and the parenchymal volume in control and EDM groups. Key words: Established Diabetes Mellitus, Placenta, Parenchyma, Neonates.   doi: 10.3329/bja.v7i1.3025 Bangladesh Journal of Anatomy January 2009, Vol. 7 No. 1 pp. 45-48

Fibrinogen Proteolysis And Platelet Activation In Myeloproliferative Disorders

1981 ◽  
Author(s):  
H Ireland ◽  
D A Lane ◽  
S Wolff ◽  
G D Pegrum
Keyword(s):  
Platelet Aggregation ◽  
Normal Values ◽  
Plasma Concentrations ◽  
Cell Mass ◽  
Myeloproliferative Disorders ◽  
Secondary Response ◽  
Platelet Response ◽  
Normal Platelet ◽  
Large Platelet ◽  
Red Cell Mass

We have studied 18 patients with myeloproliferative disorders to determine whether their abnormal platelet function and increased plasma β thromboglobulin (β TG) are associated with activated coagulation and fibrinolytic systems. Of these patients, 8 had polycythaemia rubra vera, 8 had myelofibrosis and 2 had thrombocythaemia. We measured plasma concentrations of the thrombin sensitive fragment fibrinopeptide A (FPA), the plasmin sensitive fibrinogen fragment B β1-42, and β TG by radioimmunoassay. We also studied platelet aggregation in response to ADP. Mean normal values (n = 20) for FpA, B β1-42 and βTG were 1.06, 1.59 and 0.80 pmol/ml respectively. The 18 patients showed minimal plasma thrombin and plasmin activities with a disproportionately large platelet release. Mean FpA, B β1-42 and β TG levels were 1.74, 3.31 and 3.12 pmol/ml, respectively. These patients exhibited increased, decreased and normal platelet aggregation but no specific defect was associated with any particular radioimmunoassay result. 5 of these patients, 4 of whom had increased aggregation, were treated with aspirin in sufficient doses to eliminate their secondary response to ADP. FPA and B β1-42 were not altered but β TG was reduced from 3.39 to 2.72 pmol/ml. We also studied 10 patients with idiopathic polycythaemia. These patients showed a normal platelet response to ADP. Their FPA, B β1-42 and β TG levels were similar to normal, 0.7, 1.93 and 0.97 pmol/ml respectively. We conclude that in myeloproliferative disorders (a) the increased plasma concentration of β TG is not associated with a particular platelet aggregation abnormality (b) in the majority of patients the increased β TG level is not a consequence of thrombin action (c) the raised FpA and B β1-42 plasma levels in the minority of patients cannot be attributed solely to increased red cell mass (d) much of the β TG release is probably independent of the cyclooxygenase pathway.

Thiamin Status of Gravidas Treated for Gestational Diabetes Mellitus Compared to Their Neonates at Parturition

2000 ◽  
Vol 70 (6) ◽  
pp. 317-320 ◽  
Author(s):  
Herman Baker ◽  
Steven Hockstein ◽  
Barbara DeAngelis ◽  
Bart Holland
Keyword(s):  
Diabetes Mellitus ◽  
Glucose Metabolism ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Cord Blood ◽  
Metabolic Stress ◽  
Vitamin Supplementation ◽  
Neonatal Blood ◽  
Diabetic Mothers

Since thiamin plays a role in glucose metabolism we wanted to know if blood thiamin influx from gravida to neonate was influenced by treatment of gravidas, having gestational diabetes mellitus (GDM). In this study we found thiamin hypovitaminemia in 19%, of the 77 pregnancies despite vitamin supplementation and treatment for GDM; neonates born to mothers with hypovitaminemia were also thiamin hypovitaminemic. All neonatal blood had significantly higher thiamin concentration than gravidas. Indeed, cord blood from neonates born to mothers treated with insulin for GDM had significantly higher thiamin concentration than other neonates in the study. A significant weight depression was noted in neonates born to treated GDM mothers. Healthy gravidas giving birth to macrosomia neonates, had significant thiamin hypovitaminosis, but only macrosomic neonates of treated diabetic mothers had significantly depressed blood thiamin concentrations. We noted that subclinical thiamin hypovitaminemia is prominent during pregnancy despite vitamin supplementation. Perhaps increased thiamin supplementation during pregnancy seems warranted to avoid metabolic stress in mother and fetus due to thiamin hypovitaminemia.

scholarly journals Spectrum of Cardiovascular Abnormalities in Infants Born to Diabetic Mother in a Tertiary Care Center

2019 ◽  
Vol 04 (03) ◽  
pp. 124-128
Author(s):  
A. S. Arul ◽  
A. S. Babu Kandha Kumar ◽  
K. Kiruthiga ◽  
M. Kanaga Priya ◽  
S. A. Neveythaa
Keyword(s):  
Diabetes Mellitus ◽  
Heart Disease ◽  
Care Center ◽  
Tertiary Care ◽  
Diabetic Mother ◽  
Tertiary Care Center ◽  
Cardiac Abnormality ◽  
Cardiovascular Abnormalities ◽  
Meal Plan ◽  
Diabetic Mothers

Abstract Background Diabetes mellitus is one of the most common medical problems among pregnant women. Now, gestational diabetes mellitus (GDM) is increasing and amounts to 17% in Asian women but only in 4% of American and European women. In southern India, the prevalence of GDM is 17% in urban women, 13.8% in semiurban, and 9.8% in rural women. Aim The aim of the study is to find the cardiovascular abnormalities in infants born to a diabetic mother (IDM) and the association between infant’s heart lesion and diabetes mellitus in pregnant mother in a tertiary care center. Materials and Methods All babies born to both pregestational and gestational diabetic mother were included. Information regarding maternal type of diabetes, treatment regimen, maternal glycemic control status, antenatal ultrasonogram, baby’s sex, birth weight, gestational age, and clinical features were collected. Echocardiogram was done for all the babies. Results Out of the 100 IDM, 28 babies had cardiac disease, 5 babies had cyanotic heart disease, and 23 babies had acyanotic heart disease. Out of 100 diabetic mothers, 66 were on meal plan, 21 were on oral hypoglycemic agent (OHA) metformin, and 13 were on insulin therapy. Among 66 babies whose mother was on the meal plan, 8 had cardiac abnormality. Among the 21 mothers on OHA, 7 babies had cardiac abnormality and all the 13 babies of mothers who were on insulin had cardiac abnormality which was a significant finding among the IDM. Conclusion Maternal diabetes is a significant risk factor for heart disease in the newborn. Careful evaluation and early diagnosis of heart diseases in this high-risk group is of great value. Both pregestational and gestational diabetic mothers should monitor their blood sugar and maintain it in a normal range at the time of conception and early in pregnancy to reduce the risk of congenital heart disease in IDM.

Essential Athrombia

1975 ◽  
Vol 33 (02) ◽  
pp. 278-285 ◽  
Author(s):  
Şeref Inceman ◽  
Yücel Tangün
Keyword(s):  
Platelet Aggregation ◽  
Bleeding Time ◽  
Bleeding Tendency ◽  
Clot Retraction ◽  
Platelet Factor ◽  
Prolonged Bleeding Time ◽  
Normal Platelet ◽  
Aggregation Response ◽  
Platelet Disorder ◽  
Fibrinogen Content

SummaryA constitutional platelet function disorder in a twelve-year-old girl characterized by a lifelong bleeding tendency, prolonged bleeding time, normal platelet count, normal clot retraction, normal platelet factor 3 activity and impaired platelet aggregation was reported.Platelet aggregation, studied turbidimetrically, was absent in the presence of usual doses of ADP (1–4 μM), although a small wave of primary aggregation was obtained by very large ADP concentrations (25–50 μM). The platelets were also unresponsive to epinephrine, thrombin and diluted collagen suspensions. But an almost normal aggregation response occurred with strong collagen suspensions. The platelets responded to Ristocetin. Pelease of platelet ADP was found to be normal by collagen and thrombin, but impaired by kaolin. Platelet fibrinogen content was normal.The present case, investigated with recent methods, confirms the existence of a type of primary functional platelet disorder characterized solely by an aggregation defect, described in 1955 and 1962 under the name of “essential athrombia.”

Platelet Aggregation, β-Thromboglobulin and Platelet Factor 4 in Diabetes Mellitus and in Patients with Vasculopathy

1984 ◽  
Vol 52 (03) ◽  
pp. 236-239 ◽  
Author(s):  
J Fritschi ◽  
M Christe ◽  
B Lämmle ◽  
G A Marbet ◽  
W Berger ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Platelet Aggregation ◽  
Discriminant Analysis ◽  
Plasma Levels ◽  
Platelet Activating Factor ◽  
Platelet Factor 4 ◽  
Platelet Factor ◽  
Aggregation Response ◽  
The Difference

SummaryWe have studied 155 subjects, 48 normals, 36 diabetics without complications, 44 with complications and 27 patients with macroangiopathy. β-Thromboglobulin (β-TG) and platelet factor 4 (PF4) are elevated in the patients groups. There is no correlation between the plasma levels of β-TG and the stages of either retinopathy or macroangiopathy or nephropathy. The difference is more marked between normals and diabetics with neuropathy (p = 0.026). The aggregation response to ADP and platelet activating factor (PAF) is enhanced at lower stimulator concentration. Using the β-TG, PF4 and aggregation values the discriminant analysis allows a distinction of several subgroups especially with nephropathy and neuropathy (Table 6).

scholarly journals Birth Outcomes among Diabetic Mothers Who Delivered in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Bajrond Eshetu ◽  
Yitagesu Sintayehu ◽  
Bazie Mekonnen ◽  
Woreknesh Daba
Keyword(s):  
Diabetes Mellitus ◽  
Preterm Delivery ◽  
Birth Outcomes ◽  
Fetal Outcome ◽  
Maternal Outcomes ◽  
Pregnancy Induced Hypertension ◽  
Class I Obesity ◽  
Induced Hypertension ◽  
History Of ◽  
Diabetic Mothers

Introduction. Diabetes develops in 4% of all the pregnancies worldwide, and its prevalence ranges from 1 to 14%, and 7% are complicated and results in prenatal morbidity and mortality. The disease affects women and their babies during pregnancy, labor, and delivery. However, little is known about its prevalence, birth outcomes, and associated factors in the study setting. Method. A facility-based retrospective cross-sectional study was done on all deliveries attended from January 1, 2015, to December 31, 2017, to determine the prevalence of diabetes and birth outcome. The mothers who had complete data record were identified and consecutively reviewed. The data were entered in EpiData Version 4.2 and exported to SPSS Version 23.0 for analysis. Results. Of the 14039 women who gave birth during the study period, 2.6% of them had diabetes mellitus, and from reviewed data, 54.6% had gestational diabetes and 45.4% had pregestational diabetes. Out of the diabetic mothers, 57.8% delivered by cesarean section, 39.9% by spontaneous vaginal delivery, and 26% of the pregnancies ended up with pregnancy-induced hypertension. Regarding the fetal outcome, 17.9% were preterm delivery, 17.6% macrocosmic, 9.2% respiratory distress, 10.1% low birth weight, and 65% admitted to neonatal intensive care unit. Class I obesity and history of PIH were associated with adverse maternal outcomes at aOR = 95%CI 3.8 (1.29, 8.319) and aOR = 95%CI 2.1 (1.03, 4.399), respectively. Being a house wife and preterm deliveries were associated with adverse fetal outcomes at aOR = 95%CI 2.117 (1.315, 3.405) and aOR = 95%CI 9.763 (4.560, 20.902), respectively. Conclusion. The prevalence of diabetes mellitus delivered in the hospital was 2.6%. Class I obesity and previous history of pregnancy-induced hypertension were significantly associated with adverse maternal outcomes, whereas preterm delivery and being housewife were associated with adverse fetal outcome.

scholarly journals Tyrosine kinase inhibitor–induced platelet dysfunction in patients with chronic myeloid leukemia

Blood ◽  
2009 ◽  
Vol 114 (2) ◽  
pp. 261-263 ◽  
Author(s):  
Alfonso Quintás-Cardama ◽  
Xin Han ◽  
Hagop Kantarjian ◽  
Jorge Cortes
Keyword(s):  
Platelet Aggregation ◽  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Kinase Inhibitor ◽  
Chronic Phase ◽  
Platelet Dysfunction ◽  
Normal Platelet ◽  
Closure Time ◽  
Platelet Aggregometry ◽  
Increased Risk

Abstract Dasatinib is associated with increased risk of bleeding among patients with chronic myeloid leukemia, even in the absence of thrombocytopenia, suggesting the presence of a hemostatic defect. We tested platelet aggregation in 91 patients with chronic myeloid leukemia in chronic phase either off-therapy (n = 4) or receiving dasatinib (n = 27), bosutinib (n = 32), imatinib (n = 19), or nilotinib (n = 9). All but 3 patients simultaneously receiving imatinib and warfarin had normal coagulation studies. All 4 patients off therapy had normal platelet aggregation. Impaired platelet aggregation on stimulation with arachidonic acid, epinephrine, or both was observed in 70%, 85%, and 59% of patients on dasatinib, respectively. Eighty-five percent of patients on bosutinib, 100% on nilotinib, and 33% on imatinib had normal platelet aggregation. Dasatinib 400 nM induced rapid and marked prolongation of closure time to collagen/epinephrine in normal whole blood on the PFA-100 system. In conclusion, dasatinib and, to some extent, imatinib produce abnormalities in platelet aggregometry testing.

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