scholarly journals Identification of Potential Biomarkers for Early Prediction of Gestational Diabetes

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 645-645
Author(s):  
Lauren McMichael ◽  
Catherine Johnson ◽  
Rob Fanter ◽  
Alex Brito ◽  
Noemi Alarcon ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Dietary Intervention ◽  
Post Partum ◽  
Intervention Group ◽  
First Trimester ◽  
The United States ◽  
Plasma Samples ◽  
Third Trimester ◽  
Purine Derivative ◽  
Potential Biomarkers

Abstract Objectives Gestational Diabetes Mellitus (GDM) is present in up to 10% of pregnancies in the United States. The occurrence of GDM causes severe short- and long-term complications for the mother and offspring. baby pre- and post-partum. Identification of the metabolites and potential biomarkers involved in GDM could improve the prediction of its occurence. The integration of food data with metabolite results could provide innovative diet intervention strategies. The objective of this study is to identify metabolites that differed in the first and third trimesters of GDM versus Non-GDM pregnancies. Methods Participants were 68 OW/OB pregnant women enrolled in the Healthy Beginnings Trial and completed blood draws at first (10–16 weeks) and third trimester (28–35 weeks).  Participants from the control and dietary intervention group who developed GDM (n = 34; GDM group) were matched on age, BMI, ethnicity, and treatment group with those who did not develop GDM (n = 34; Non-GDM group). Plasma samples were analyzed by ultra-high-performance liquid chromatography-hybrid triple-quadrupole linear ion trap mass spectrometry (UPLC-QTRAP) using three targeted metabolomics assays for primary metabolomics, aminomics and lipdomics. Dietary intake was estimated using 24 hour recalls in order to assess potential dietary differences between groups. Results A total of 243 metabolites were identified in the plasma samples. At first trimester, several complex lipids, including cholestryl esters and phospholipids, were higher in the GDM group (P < 0.05). Furthermore, the purine derivative hypoxanthine was also higher in GDM subjects (P < 0.05). At third trimester, multiple acylcarnitines, associated with utilization of fat for energy, were lower in the GDM group (P < 0.05). Conclusions Metabolite differences between GDM and Non-GDM groups in plasma samples collected during first trimester may predict the development of GDM. Further research is required to identify the roles these metabolite changes play in the development of this disease. Funding Sources NIH National Heart, Lung, and Blood Institute (NHLBI; HL114377), ARI #58,875, Cal Poly CAFES SURP.

scholarly journals First Trimester Metabolites Predict Gestational Diabetes Mellitus Diagnosis: A Case: Control Study (FS03-04-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Manuel Ramos ◽  
Anna Lamb ◽  
Noemi Alarcon ◽  
Adilene Quintana-Diaz ◽  
Rob Fanter ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Dietary Intervention ◽  
Intervention Group ◽  
First Trimester ◽  
Case Control ◽  
Plasma Metabolites ◽  
Blood Draw ◽  
Increased Risk

Abstract Objectives Gestational Diabetes Mellitus (GDM) has an overall prevalence estimated as high as 13% of overweight/obese (OW/OB) pregnant women. Since the occurrence of GDM can have a combination of adverse perinatal outcomes and long-term increased risk of health issues in the future for both the mother and child, it is important that the mechanisms involved in this disease are better understood so that better prevention strategies can be devised. We sought to identify early and late pregnancy metabolites that discriminated women who developed vs. did not develop GDM to provide insight into its etiology and help improve treatments. Methods Participants were 26 OW/OB women enrolled in the Healthy Beginnings Trial and completed blood draws at 13 weeks, 26 weeks, and 35 weeks gestation. Participants from the control and dietary intervention group who developed GDM (N = 12) were matched on age and study entry BMI with those who did not develop GDM (N = 14). Plasma samples were analyzed by ultra-high-performance liquid chromatography-hybrid triple‐quadrupole linear ion trap mass spectrometry (UPLC-QTRAP) using two targeted metabolomics assays for primary metabolomics and aminomics. Results A total of 142 metabolites were identified. Most metabolite differences were observed during the first trimester blood draw, prior to GDM diagnosis. At first trimester, metabolites related to energy metabolism that were altered included lower levels of alpha-ketoglutarate and glycerol-3-phosphate, as well as the medium-chain acylcarnitines’ lauroyl-carnitine, dodecenoyl-carnitine, and octanoyl-carnitine (P < 0.05). Interestingly, the neurotransmitters serotonin and glutamate were elevated in subjects who later developed GDM (P < 0.01). In regards to the observed elevated creatine, the lower concentrations of methionine and glycine may suggest utilization of these amino acids for its production (P < 0.03). Lastly, the gut microbiota-derived indole-3-propionate was higher in GDM cases (P < 0.05). In the third trimester of the GDM group, only levels of 4-pyridoxate (vitamin B-6) were lowered (P < 0.05). Conclusions Metabolic changes associated with the numerous plasma metabolites that were different between GDM case-control subjects during first trimester may predict the development of this condition. Funding Sources NIH, ARI.

scholarly journals Radioimmunoassay of plasma ouabain in healthy and pregnant individuals

2000 ◽  
Vol 165 (3) ◽  
pp. 669-677 ◽  
Author(s):  
O Vakkuri ◽  
SS Arnason ◽  
A Pouta ◽  
O Vuolteenaho ◽  
J Leppaluoto
Keyword(s):  
Pregnant Women ◽  
Human Plasma ◽  
High Performance ◽  
Chemical Nature ◽  
Solid Phase ◽  
Plasma Concentrations ◽  
First Trimester ◽  
Plasma Samples ◽  
Third Trimester ◽  
Endogenous Substances

Ouabain was recently isolated from human plasma, bovine hypothalamus and bovine adrenal in attempts to identify endogenous substances inhibiting the cell membrane sodium pump. A number of radioimmunoassays have been developed in order to study the clinical significance of ouabain. The results have been controversial with regard to the presence and chemical nature of plasma ouabain-like immunoreactivity. We have now measured ouabain in healthy and pregnant individuals using solid-phase extraction of plasma samples followed by a new radioimmunoassay with the extraordinary sensitivity of at least 2 fmol/tube (5 pmol/l). Plasma extracts, a previously isolated human plasma ouabain-like compound and bovine hypothalamic inhibitory factor displaced the tracer in parallel and eluted identically with ouabain in high-performance liquid chromatography. Plasma ouabain immunoreactivity was found to be much lower than reported previously: 12.6+/-1.3 pmol/l in healthy men (mean+/-s.e., n=20) and 9.4+/-0.7 pmol/l in women (n=14). In pregnant women (n=28) plasma ouabain concentration was 16.3+/-4.0 pmol/l during the first trimester, 18.8+/-4.3 pmol/l during the second trimester and 24.3+/-4.0 pmol/l during the third trimester (all P<0.01 compared with non-pregnant women). Plasma ouabain 3-5 days after the delivery was 13.6+/-1.1 pmol/l (n=10, P<0.05-0.01 compared with second and third trimesters). The pregnancy-related changes in the plasma concentrations of ouabain resembled those of cortisol. Therefore cortisol was measured from the same plasma samples and a significant positive correlation was found (r=0.512, P=0.006). The similar profiles of plasma ouabain and cortisol during pregnancy and their rapid decreases postpartum are consistent with the adrenal cortical origin of ouabain and also show that the secretions of these hormones are possibly under the control of same factors.

scholarly journals OBSTETRICAL ACUTE RENAL FAILURE;

2013 ◽  
Vol 20 (03) ◽  
pp. 429-432
Author(s):  
AMBREEN GHORI ◽  
CHANDRA MADHUDAS ◽  
FERKHUNDA KHURSHID ◽  
Jamila Siakndari ◽  
Tarachand Devrajani ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Post Partum ◽  
First Trimester ◽  
Health Care Facilities ◽  
University Hospital ◽  
Third Trimester ◽  
Care Facilities ◽  
Poor Health Care ◽  
One Year

Background & Objective: Acute renal failure is one of serious complication in pregnancy, in first trimester is usuallyrelated to unregulated and septic miscarriage while in third trimester it is due to obstetric complications. This prospective case seriousdescriptive study was conducted to determine the frequency, etiology and outcome of patients suffering from acute renal failure.Settings: Department of Gynecology & Obstetric at Liaquat University Hospital Hyderabad. Duration: One year (from 1st June 2011 to31st May 2012) Patients and Methods: Patients admitted in labor room during antepartum, intrapartum or post partum period werescrutinized by history, clinical examination, and investigations. Those with urine output less than 50cc in 24hours were defined as case ofARF. Predesigned proforma filled to analyze etiology and outcome of patients with acute renal failure. Results: Out of 3220 patientsadmitted, 35 patients presented with acute renal failure giving incidence of 1.080%. APH(28.57%), PPH(25.7%), P.sepsis (14.28%) andHypertensive disorder(5.14%) were leading cause of ARF. 60% patients recovered from injury and mortality in these patients were 11.4%.Conclusions: Poor health care facilities and lack of quality antenatal healthcare clinics were the major identified causes.

scholarly journals COMPARATIVE STUDY OF TREATMENT OF GESTATIONAL DIABETES MELLI-TUS CITED IN VARIOUS AYURVEDIC AND MODERN RESEARCH PAPERS PUB-LISHED IN LAST 5 YEARS

2020 ◽  
Vol 08 (11) ◽  
pp. 5081-5088
Author(s):  
Swati S. Mohite ◽  
Rahul Gajare ◽  
Namrata B. Khose
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Antioxidant Properties ◽  
Supportive Therapy ◽  
Good Health ◽  
Maternal Diabetes ◽  
First Trimester ◽  
Tinospora Cordifolia ◽  
Third Trimester ◽  
Intrauterine Development

Gestational Diabetes Mellitus is a metabolic disorder during pregnancy. It is defined by WHO as carbohy-drate intolerance resulting in hyperglycemia of variable severity with onset or first recognition during preg-nancy. The entity usually present late in second and third trimester. The factors which constitute good health, i.e. balanced Dosha, Dhatu and Mala, optimally functioning Indriyas or sense organs, a happy con-tented soul and a balanced mind are the very factors that go towards a smooth pregnancy, labour and healthy progeny and this is what Ayurveda treatment focuses on. Pregnancy is a particular time for all women. This condition becomes even more delicate when there is diagnosis of GDM which makes neces-sary controls and therapies that will inevitably affect the women’s life. GDM can lead to potential risk for mother, fetus and child’s development. There is no direct reference of GDM in Ayurveda. But we get ref-erence of Garbhavriddhi excessive increase in size of abdomen and perspiration. Garbhavriddhi or mac-rosomia condition can be interpreted as complication of GDM. In current scenario GDM in pregnancy is one of the major complications during pregnancy. Overt maternal diabetes mellitus can adversely influence intrauterine development. Spontaneous abortions and major congenital anomalies may be induced in the first trimester. Excessive foetal growth, neonatal hypoglycemia, still birth may be induced during second and third trimester. Gestational Diabetes may lead to gangrene, damage of retina, kidneys. If diabetes is not properly controlled, then in the long run fat gets deposited on inner layer of arteries and the possibilities of occurrence of paralysis increase. Complications of diabetes include eye problems and blindness, heart dis-ease, stroke, neurological problems, amputation, and impotence It is needed to cure maternal diabetes as soon as it is diagnosed. Adopting pre-conceptional and thorough antenatal care through Ayurveda; this aims that a woman enters pregnancy in healthy state of body and mind. While describing Garbhadhan vidhi acharyas have advised certain body purifying measures (Sanshodhana karma) followed by special dietet-ics and mode of life for the couple. Ayurveda focuses on change in lifestyle of the Garbhini which helps in maternal health and fetal growth minimizing the complications related to pregnancy. Ayurveda efforts of having healthy baby commences with pre-conception care and management. Pre-conception counselling, Diet, Herbs, Yoga, Asanas are useful as a supportive therapy together with modern medication under su-pervision. The best way to improve your diet is by eating a variety of healthy foods. Various vegetables, pulses, spices, cereals, fruits, dry fruits are helpful in GDM patients. Daily 20 mins walk is also helpful. Ayurvedic herbs like Guduchi, Amalaki, Haritaki, Haridra, Bilva, Neem, Jamun are also useful in GDM. They are having antidiabetic, antioxidant properties. Tinospora Cordifolia are potential therapeutics that act as anti-diabetic drug in the prevention and treatment of GDM. Metformin is safe and effective drug in treatment of GDM. Combination of metformin, diet, Ayurvedic herbs, preconception counselling, Yoga, Pranayama and meditation can give best result in GDM.

scholarly journals Transient diabetes insipidus in pregnancy

2015 ◽  
Vol 2015 ◽  
Author(s):  
Pedro Marques ◽  
Kavinga Gunawardana ◽  
Ashley Grossman
Keyword(s):  
Liver Function ◽  
Gestational Diabetes ◽  
Diabetes Insipidus ◽  
Pregnant Women ◽  
Serum Sodium ◽  
Post Partum ◽  
Rare Complication ◽  
Urine Osmolality ◽  
Third Trimester ◽  
Serum And Urine

Summary Gestational diabetes insipidus (DI) is a rare complication of pregnancy, usually developing in the third trimester and remitting spontaneously 4–6 weeks post-partum. It is mainly caused by excessive vasopressinase activity, an enzyme expressed by placental trophoblasts which metabolises arginine vasopressin (AVP). Its diagnosis is challenging, and the treatment requires desmopressin. A 38-year-old Chinese woman was referred in the 37th week of her first single-gestation due to polyuria, nocturia and polydipsia. She was known to have gestational diabetes mellitus diagnosed in the second trimester, well-controlled with diet. Her medical history was unremarkable. Physical examination demonstrated decreased skin turgor; her blood pressure was 102/63 mmHg, heart rate 78 beats/min and weight 53 kg (BMI 22.6 kg/m2). Laboratory data revealed low urine osmolality 89 mOsmol/kg (350–1000), serum osmolality 293 mOsmol/kg (278–295), serum sodium 144 mmol/l (135–145), potassium 4.1 mmol/l (3.5–5.0), urea 2.2 mmol/l (2.5–6.7), glucose 3.5 mmol/l and HbA1c 5.3%. Bilirubin, alanine transaminase, alkaline phosphatase and full blood count were normal. The patient was started on desmopressin with improvement in her symptoms, and normalisation of serum and urine osmolality (280 and 310 mOsmol/kg respectively). A fetus was delivered at the 39th week without major problems. After delivery, desmopressin was stopped and she had no further evidence of polyuria, polydipsia or nocturia. Her sodium, serum/urine osmolality at 12-weeks post-partum were normal. A pituitary magnetic resonance imaging (MRI) revealed the neurohypophyseal T1-bright spot situated ectopically, with a normal adenohypophysis and infundibulum. She remains clinically well, currently breastfeeding, and off all medication. This case illustrates some challenges in the diagnosis and management of transient gestational DI. Learning points Gestational DI is a rare complication of pregnancy occurring in two to four out of 100 000 pregnancies. It usually develops at the end of the second or third trimester of pregnancy and remits spontaneously 4–6 weeks after delivery. Gestational DI occurrence is related to excessive vasopressinase activity, an enzyme expressed by placental trophoblasts during pregnancy, which metabolises AVP. Its activity is proportional to the placental weight, explaining the higher vasopressinase activity in third trimester or in multiple pregnancies. Vasopressinase is metabolised by the liver, which most likely explains its higher concentrations in pregnant women with hepatic dysfunction, such acute fatty liver of pregnancy, HELLP syndrome, hepatitis and cirrhosis. Therefore, it is important to assess liver function in patients with gestational DI, and to be aware of the risk of DI in pregnant women with liver disease. Serum and urine osmolality are essential for the diagnosis, but other tests such as serum sodium, glucose, urea, creatinine, liver function may be informative. The water deprivation test is normally not recommended during pregnancy because it may lead to significant dehydration, but a pituitary MRI should be performed at some point to exclude lesions in the hypothalamo-pituitary region. These patients should be monitored for vital signs, fluid balance, body weight, fetal status, renal and liver function, and treated with desmopressin. The recommended doses are similar or slightly higher than those recommended for central DI in non-pregnant women, and should be titrated individually.

scholarly journals Relative Contribution of Gestational Weight Gain, Gestational Diabetes, and Maternal Obesity to Neonatal Fat Mass

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3434
Author(s):  
Delphine Mitanchez ◽  
Sophie Jacqueminet ◽  
Said Lebbah ◽  
Marc Dommergues ◽  
David Hajage ◽  
...  
Keyword(s):  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Weight Gain ◽  
Body Fat ◽  
Dietary Intervention ◽  
Maternal Obesity ◽  
Secondary Analysis ◽  
Third Trimester ◽  
Gestational Weight ◽  
Relative Contribution

Maternal nutritional and metabolic status influence fetal growth. This study investigated the contribution of gestational weight gain (GWG), gestational diabetes (GDM), and maternal obesity to birthweight and newborn body fat. It is a secondary analysis of a prospective study including 204 women with a pregestational body mass index (BMI) of 18.5–24.9 kg/m2 and 219 women with BMI ≥ 30 kg/m2. GDM was screened in the second and third trimester and was treated by dietary intervention, and insulin if required. Maternal obesity had the greatest effect on skinfolds (+1.4 mm) and cord leptin (+3.5 ng/mL), but no effect on birthweight. GWG was associated with increased birthweight and skinfolds thickness, independently from GDM and maternal obesity. There was an interaction between third trimester weight gain and GDM on birthweight and cord leptin, but not with maternal obesity. On average, +1 kg in third trimester was associated with +13 g in birthweight and with +0.64 ng/mL in cord leptin, and a further 32 g and 0.89 ng/mL increase in diabetic mothers, respectively. Maternal obesity is the main contributor to neonatal body fat. There is an independent association between third trimester weight gain, birthweight, and neonatal body fat, enhanced by GDM despite intensive treatment.

BIOMECHANICAL EVALUATION ON GAIT PATTERN OF PREGNANT SUBJECTS

2002 ◽  
Vol 02 (01) ◽  
pp. 99-116 ◽  
Author(s):  
N. A. ABU OSMAN ◽  
R. MAT GHAZALI
Keyword(s):  
Post Partum ◽  
Normal Subjects ◽  
First Trimester ◽  
Gait Pattern ◽  
The Body ◽  
Step Width ◽  
Third Trimester ◽  
Anatomical Changes ◽  
Biomechanical Evaluation ◽  
The Subject

Many physiological and anatomical changes occurring during the pregnancy period have been widely documented and reported in the literature. This study involved the participation of pregnant subjects, divided into their respective trimester periods, with post-partum normal subjects. Kinetics analyses were performed on each subject using the Peak Motus 2000 system, and comparison between the pregnant subjects in different trimester, and also the post-partum normal subjects, were conducted. The step width generally increases as the subject is progressing through her pregnancy periods. From the average, the step width increases from 0.168 m in the first trimester to 0.350 m in the third trimester, which is an increase of nearly 50%. It can be generally appreciated that the step width increases as the pregnancy period progresses. It shows that these increases may be attributed to the increase of the body weight of the subject as she gains more weight towards the end of her pregnancy.

scholarly journals Combination of Pectoralis Major Muscle Massage and Endorphine Massage in Trimester III Pregnant Women for the Removal of Post Partum ASI in Palu City

2019 ◽  
pp. 137-147
Author(s):  
Rafika Uddin ◽  
Sri Yanti Kusika
Keyword(s):  
Breast Milk ◽  
Pregnant Women ◽  
Health Center ◽  
Post Partum ◽  
Pectoralis Major Muscle ◽  
Intervention Group ◽  
Pectoralis Major ◽  
Control Group ◽  
Third Trimester ◽  
Average Volume

The inhibiting factor in breastfeeding is the production of breastfeeding it self. The production of breast milk which is less and slowly exits can cause the mother not to give enough milk to her baby. Stimulating breastmilk production can be done by trying to stimulate prolactin and oxytocin hormones including by carrying out breast care on the skin, through pectoralis major muscle massage and endorphine massage to accelerate oxygen and make the mother feel relaxed. The aim of the study was to determine the effect of the combination of pectoralis major muscle massage and endorphine massage in third trimester pregnant women on breast milk release in post partum mothers. This type of research is quasi-experimental  with the design of the Static-Group Comparasion. The study was conducted in September-November 2018 in the area of the Kamonji Health Center in the City of Palu. The population consisted of an intervention group of 24 people combined treatment of pectoralis major muscle massage followed by endorphine massage, and a control group of 24 people not given treatment. Sampling using the executive sampling technique. Univariate analysis and bivariate analysis. The results of this study obtained by the intervention group had an average volume of breast milk of 1.36 cc, a minimum value of 05, cc and a maximum of 2.3 cc. while the control group has an average value of 0.38 cc, a minimum value of 0.1 cc and a maximum of 0.8 cc. it means there is a difference in the average volume of breast milk in the intervention group higher than the control group. This result is based on thestatistic Mann-Whitney Test obtained p value = 0,000. It was concluded, the combination of major pectoralis muscle massage and endorphine massage in third trimester pregnant women was effective against post partum breast milk release. Suggestion, the need for health center officers to apply this complementary therapy so that the target of exclusive breastfeeding is achieved.

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