scholarly journals Ultrasound investigation in pregnant women with diabetes mellitus

2021 ◽  
Vol 11 (8) ◽  
pp. 480-490
Author(s):  
M. Medvedeva ◽  
D. Tertyshnyk ◽  
I. Safonova ◽  
V. Lazurenko ◽  
I. Borzenko
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Clinical Laboratory ◽  
Main Group ◽  
Control Group ◽  
Perinatal Pathology ◽  
Cheap Method ◽  
Invasive Method ◽  
Narrow Pelvis

Introduction. Ultrasound (US) has been used in obstetrics for more than 30 years and is considered to be reliable, simple, quick in results, painless and cheap method. The aim: to optimize the use of US in childbirth in pregnant women with diabetes and determine the outcome of childbirth, taking into account the condition of the fetus and newborn. Materials and methods. 52 pregnant women, among them 32 with diabetes mellitus (pre-gestational diabetes was in 20 persons and 12 persons had gestational diabetes) have been examined.  The average age of pregnant women in the main group was 29.8 ± 5.4 years, in the control group - 25.7 ± 4.3 years. All women in the main and control groups were primiparous. The gestation period in the main group was 39.1 ± 0.5 weeks [38.0; 39.6], in the control group - 39.5 ± 0.7 [38.4; 40.5] weeks. Clinical-laboratory and instrumental examinations were made. Control group consisted of  20 physiologically pregnant women. To determine the condition and size of the fetus and its progress in labor, immediately at the end of the first and during the second staage of labor, transabdominal and transperineal US and Doppler examination were performed with device HD 11 XE Phillips (USA). Results. Pregnant women with diabetes are more likely to have a pathological second stage of labors due to macrosomia and problems with the birth of the fetus, as evidenced by the lack of increased angle of progress and decreased head-perineal distance. The data obtained indicate the prospects of using ultrasound in childbirth as an objective non-invasive method for predicting the likelihood of vaginal birth, which will reduce operative delivery and perinatal pathology. Conclusions. The use of ultrasound in childbirth in women with diabetes and diabetic fetopathy can determine the possibility of complications in the promotion of the fetus, including clinical narrow pelvis, shoulder dystocia, the occurrence of distress, as evidenced by the Apgar scale and CLS. Intraparietal ultrasound helps to guide the plan of childbirth, reduce the frequency of cesarean delivery, perinatal morbidity and mortality, and birth trauma.

scholarly journals FEATURES OF MICROBIOLOGICAL AND IMMUNE STATE IN PREGNANT WOMEN WITH INFLAMMATORY PERIODONTAL DISEASES AGAINST THE BACKGROUND OF GESTATIONAL DIABETES MELLITUS

2020 ◽  
Vol 75 (3) ◽  
pp. 83-86
Author(s):  
Ye.I. Alexandrov ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Oral Cavity ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Periodontal Diseases ◽  
Main Group ◽  
Control Group ◽  
Periodontal Health ◽  
Periodontal Tissues

90 pregnant women with inflammatory periodontal diseases, aged 27 to 35 years were examined. The main group consisted of 60 pregnant women with gestational diabetes mellitus and the control one consisted of 30 patients with physiological pregnancy. All patients were examined before providing treatment and preventive measures at 14–15 weeks of pregnancy and after them at 37–38 weeks. Studies have shown deterioration in periodontal health, oral hygiene and increase in contamination of the oral cavity in patients of the main group as compared with patients of the control group. The use of the anti-inflammatory succinic acid based preparation is effective for inflammatory periodontal diseases in pregnant women with gestational diabetes. The improvement of periodontal tissues health was confirmed by the posttreatment indices of hygiene, immunoglobulins, microbiocenosis and periodontal indices that promote normalization of the oral cavity.

Thyroid Dysfunction in Pregnant Women with Gestational Diabetes Mellitus

2020 ◽  
Vol 16 (8) ◽  
pp. 895-899 ◽  
Author(s):  
Shahin Safian ◽  
Farzaneh Esna-Ashari ◽  
Shiva Borzouei
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Thyroid Dysfunction ◽  
Control Group ◽  
Thyroid Peroxidase ◽  
Free T4 ◽  
Significant Difference ◽  
Experimental Group

Aims: Investigation thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes mellitus. Background: This article was written to evaluate the thyroid function and anti-thyroid peroxidase (anti- TPO) antibodies in pregnant women with gestational diabetes mellitus (GDM). Method: A total of 252 women with GDM and 252 healthy pregnant women were enrolled. Thyroid tests, including TSH, FreeT3, Free T4, and anti-TPO were performed for all women at 24–28 weeks of gestation. Data analysis was then carried out using SPSS ver. 22. Result: There was a significant difference between the experimental group (38.4%) and the control group (14.06%) in terms of the prevalence of subclinical hypothyroidism (p= 0.016). The frequency of anti-TPO was higher in the experimental group than the control group and positive anti-TPO was observed in 18.6% of women with GDM and 10.3% of healthy pregnant women (P= 0.008). Conclusion: Thyroid disorders are observed in pregnant women with GDM more frequently than healthy individuals and it may be thus reasonable to perform thyroid tests routinely.

scholarly journals Evaluation of epicardial fat tissue thickness and aortic stiffness in patients with gestational diabetes mellitus

2021 ◽  
Vol 29 (1) ◽  
pp. 33-38
Author(s):  
Melike Nur Akın ◽  
Burcu Kasap ◽  
Fatih Akın ◽  
Burak Sezgin ◽  
İbrahim Altun ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Aortic Stiffness ◽  
Epicardial Fat ◽  
Control Group ◽  
Fat Tissue ◽  
Tissue Thickness ◽  
Epicardial Fat Tissue

Objective We aimed to assess the relationship between gestational diabetes mellitus and coronary artery disease by measuring epicardial fat tissue thickness and aortic stiffness in pregnant women diagnosed with gestational diabetes mellitus. Methods 28 pregnant women diagnosed with gestational diabetes mellitus and 25 pregnant women without gestational diabetes mellitus were included in the research. Body mass index, laboratory values, blood pressure measurements and obstetric history findings of the study population were recorded. All participants of the study population were evaluated with transthoracic echocardiography between 24 and 28 weeks of gestational period. The measurement of epicardial fat tissue thickness was taken and aortic stiffness index was also calculated. Results The age, gravidity, parity and obstetric history of the two groups were similar. Epicardial fat tissue thickness was found significantly higher in gestational diabetes mellitus group than control group (0.416 cm and 0.336 cm, respectively; p<0.001). However, no significant difference was found in aortic stiffness measurements of the two groups (p=0.079). Conclusion According to the results of our study, epicardial fat tissue thickness was found to be statistically significantly higher in pregnant women with gestational diabetes mellitus compared to the control group. The fact that no difference was detected in other cardiovascular parameters suggests that measurement of epicardial fat tissue thickness in gestational period may be a beneficial adjunctive tool in early detection of gestational diabetes mellitus.

scholarly journals Complications of the Early Neonatal Period in Children from Mothers with Gestational Diabetes Mellitus

2021 ◽  
Vol 11 (4) ◽  
pp. 414-417
Author(s):  
Agamurad Orazmuradov ◽  
Irina Bekbaeva ◽  
Gayane Arakelyan ◽  
Anastasia Minaeva ◽  
Anastasiya Akhmatova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Therapy Group ◽  
Control Group ◽  
Balanced Diet ◽  
Functional Immaturity ◽  
Group 2 ◽  
Group 1

Background: Changes in the course of gestational diabetes mellitus (GDM) at the present stage determine the emergence of a certain spectrum of completely new problems associated with the health status of newborns from mothers with GDM. The aim of the study was to investigate early neonatal complications in newborns from mothers with GDM. Methods and Results: The study included 404 pregnant women (gestational age of 37.0–41.0 weeks) with GDM. All patients with GDM were divided into 2 groups. Group 1 included 188 patients receiving insulin therapy; Group 2 included 216 patients receiving a well-balanced diet. The control group (Group 3) consisted of 68 pregnant women without disorders of carbohydrate metabolism. In Group 1, macrosomia occurred in 44(23.4%) newborns, in Group 2 - in 48(22.0%) newborns; in newborns from mothers of the control group, the frequency of macrosomia was only in 7.35% of newborns (P=0.01). Morpho-functional immaturity of newborns had the highest frequency of occurrence, despite the fact that all children were born on time; 80(42.6%) newborns from mothers of Group 1 and 77(35.6%) newborns from mothers of Group 2 had signs of morpho-functional immaturity. Conclusion: Diabetic fetopathy in newborns from mothers with GDM is manifested by morpho-functional immaturity of organs and systems developing in unfavorable hyperglycemic conditions.

scholarly journals Increased Serum Pigment Epithelium-Derived Factor in Women with Gestational Diabetes Is Associated with Type 2 Diabetes

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Tong-Huan Li ◽  
Chun-Jian Qiu ◽  
Xiao-Juan Yu ◽  
Dan-Dan Liu ◽  
Peng-Fei Zhou ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Fasting Glucose ◽  
Pigment Epithelium ◽  
Control Group ◽  
Pigment Epithelium Derived Factor

Background. Pigment epithelium-derived factor (PEDF) is demonstrated to be elevated in diabetes patients. However, no reports have emerged in pregnant women with gestational diabetes mellitus (GDM). This study was undertaken to investigate serum PEDF levels in GDM women and to evaluate PEDF as a biomarker to predict diabetes postpartum.Methods. Serum PEDF concentration and clinical characteristics were detected in the pregnant women with GDM (n = 120) and without GDM (control group,n = 120).Results. PEDF levels were elevated in subjects with GDM versus controls. Univariate correlations showed that serum PEDF levels were positively correlated with fasting glucose and fasting insulin levels, respectively, and negatively correlated with adiponectin. Receiver operating characteristic (ROC) analysis demonstrated that the AUC of serum PEDF for diabetes mellitus in women postpartum was 0.893.Conclusion. Serum PEDF was elevated in pregnant women with GDM, which is probably an early detection marker for predicting development of GDM to diabetes mellitus.

Changes of Serum Sex Hormone-Binding Globulin, Homocysteine, and Hypersensitive CRP Levels during Pregnancy and Their Relationship with Gestational Diabetes Mellitus

2021 ◽  
pp. 1-7
Author(s):  
Wenhua Liu ◽  
Zheren Huang ◽  
Shanshan Tang ◽  
Zhifen Zhang ◽  
Qing Yu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Serum Levels ◽  
First Trimester ◽  
Sex Hormone Binding Globulin ◽  
Control Group ◽  
Second Trimester ◽  
Hormone Binding ◽  
Hs Crp

<b><i>Background:</i></b> Inflammatory response state is related to the pathogenesis of gestational diabetes mellitus (GDM). <b><i>Objective:</i></b> To investigate the changes of serum sex hormone-binding globulin (SHBG), homocysteine (Hcy), and hypersensitive CRP (hs-CRP) levels during pregnancy and their relationship with GDM. <b><i>Methods:</i></b> The nested case-control study method was used. Sixty nonobese single pregnant women diagnosed with GDM were divided into the GDM group (GDM, <i>n</i> = 60), together with another 60 pregnant women with normal glucose tolerance who were matched in the same period and divided into the control group (control, <i>n</i> = 60). The serum Hcy, hs-CRP, and SHBG levels were measured. <b><i>Results:</i></b> The serum levels of Hcy and hs-CRP were significantly higher in the GDM group compared with the control group, and serum levels of SHBG was significantly lower in the GDM group compared with the control group at different stages of pregnancy. The serum levels of Hcy and hs-CRP in pregnant women increased with the increase of gestational age, and serum levels of SHBG decreased with the increase of gestational age. Increased Hcy and hs-CRP levels in the second trimester and decreased SHBG levels in the first trimester were related to GDM. The odds ratio (OR) and 95% confidence interval (CI) were as follows: OR: 4.5, 95% CI: 1.5–13.0; OR: 4.2, 95% CI: 1.5–10.1; and OR: 0.4, 95% CI: 0.3–0.7, respectively. <b><i>Conclusion:</i></b> Increased Hcy and hs-CRP in the second trimester and decreased SHBG in the first trimester were independent predictors of GDM, which provides a new idea for early prevention and treatment of GDM.

Role of the fetal pancreas size in prediction of early neonatal hypoglycemia in maternal diabetes mellitus

2021 ◽  
pp. 62-70
Author(s):  
С.Н. Лысенко ◽  
М.А. Чечнева ◽  
Ф.Ф. Бурумкулова ◽  
В.А. Петрухин ◽  
Т.С. Будыкина
Keyword(s):  
Diabetes Mellitus ◽  
Pregnant Women ◽  
Premature Infants ◽  
Linear Correlation ◽  
Clinical Symptoms ◽  
Maternal Diabetes ◽  
Main Group ◽  
Control Group ◽  
Neonatal Hypoglycemia ◽  
Fetal Pancreas

Введение. Поджелудочная железа (ПЖ) плода играет роль в регуляции гликемии как у плода, так и у матери. Гипергликемия матери, независимо от типа сахарного диабета (CД) сопровождается гипергликемией у плода. Напряжение функции ПЖ плода обусловливает компенсаторное увеличение eё размеров, формирование фетальной гиперинсулинемии и развитие в первые часы жизни неонатальной гипогликемии. Клинические симптомы гипогликемии присутствуют в 25-33% случаев, частота лабораторной гипогликемии - в 21-60%. Цель - оценка прогностического значения увеличения размеров ПЖ плода накануне родов в качестве предиктора неонатальной гипогликемии при CД у матери. Методика. Проведена ультразвуковая морфометрия ПЖ у 241 беременной c CД (основная группа) и у 427 здоровых беременных (контрольная группа). В основной группе у 141 (58,5%) беременной родились дети c признаками диабетической фетопатии (ДФ). Оценивались размеры ПЖ плода. У новорождённых оценивалась гликемия в динамике в 1-e и 3-и сут жизни. Проведён ретроспективный корреляционный анализ размеров поджелудочной железы плода и характер гликемии новорожденных в 1-e и 3-и cут жизни. Результаты. Выявлена отрицательная корреляция толщины ПЖ и гипогликемии новорождённого в 1-e сут жизни c линейным коэффициентом корреляции (R) минус 0,66. В 1-e сут жизни у 87,5 % этих детей возникает гипогликемия, более выраженная у недоношенных, у 50% из них, сохраняющаяся к 3-м сут жизни. Заключение. Толщина ПЖ плода более информативный и воспроизводимый показатель, чем её длина, статистически значимый как в группе ДФ, так и без неё. Неудовлетворительный контроль за течением CД у матерей увеличивает риск гипогликемии новорождённого до 100%. Более выраженная гипогликемия выявляется у недоношенных детей, у половины которых гипогликемия сохраняется к 3-м сут жизни. Background. The fetal pancreas is involved in regulation of glucose levels in both fetal and maternal plasma. Maternal hyperglycemia, regardless of the type of diabetes mellitus (DM), is accompanied by fetal hyperglycemia. This stress of the fetal pancreatic function causes a compensatory increase in the pancreas size, the development of fetal hyperinsulinemia and of neonatal hypoglycemia in the first hours of life. The frequency of laboratory hypoglycemia varies 21-60%, while its clinical symptoms are present in 25-33% of cases. Aim. To assess the prognostic value of the increase in fetal pancreas size on the eve of delivery as a predictor of neonatal hypoglycemia in maternal DM. Methods. Ultrasound of the fetal pancreas was performed in 241 pregnant women with DM (main group) and in 427 healthy pregnant women (control group). In the main group, 141 (58.5%) pregnant women had children with signs of diabetic fetopathy (DF). The size of the fetal pancreas was estimated. In newborns, glycemia was measured on the 1st and 3rd days of life. A retrospective correlation analysis of the fetal pancreas size and the neonatal glycemia was performed on the 1st and the 3rd days of life. Results. A negative linear correlation was found between the pancreas thickness and neonatal hypoglycemia on the 1st day of life (linear correlation coefficient, R, -0.66). On the 1st day of life in 87.5-100% of these newborns, hypoglycemia is observed, which is more pronounced in premature infants and which remains through the 3rd day of life in 50% of them. Conclusion. The thickness of the fetal pancreas is a more informative and reproducible indicator than its length, which was statistically significant in groups both with and without DF. Poor glycemic control in mothers increases the risk of neonatal hypoglycemia up to 100%. More pronounced hypoglycemia is observed in premature infants and persists through the 3rd day of life in half of them.

Study of retinal blood flow in pregnant women with diabetes mellitus

2021 ◽  
pp. 117-120
Author(s):  
N.V. Pomytkina ◽  
◽  
E.L. Sorokin ◽  
Y.E. Pashentsev ◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Flow ◽  
Optical Coherence Tomography ◽  
Pregnant Women ◽  
Main Group ◽  
Retinal Blood Flow ◽  
Control Group ◽  
Vascular Density ◽  
Third Trimester ◽  
The Third

Purpose. To investigate changes in retinal blood flow in pregnant women with diabetes mellitus (DM) using optical coherence tomography in angiography (OCTA) mode. Material and methods. 60 pregnant women were examined. The main group consisted of 24 women with DM type 1 and type 2. The control group was represented by 36 healthy women with physiological pregnancy. Women underwent OCTA on an Optovue RTVue XR Avanti device (Optovue Inc., USA) using the HD Angio Retina 6.0 mm scanning protocol. The total vascular density (TVD), foveal vascular density (FVD), and the area of the foveal avascular zone (AFAZ) in the superficial retinal plexus were studied. The survey was carried out in all trimesters of pregnancy in the main group, in the control group – in the third trimester. Results. When conducting a comparative analysis, no significant differences in the values of TDV and AFAZ were found between the main group and the control group. FVD values in pregnant women with diabetes were statistically significantly lower relative to the control group (p=0.001). There were no significant differences in FVD values in the subgroups of pregnant women with diabetic retinopathy (DR) and with diabetes and the absence of DR in the third trimester (p=0.114). However, AFAZ indices in patients with DR were significantly higher (p=0.039), and TDV – significantly lower in comparison with pregnant women with diabetes and no DR (p=0.035). Conclusions. 1. In pregnant women with diabetes in the third trimester, a statistically significant decrease in FPS in the superficial retinal plexus was revealed in comparison with healthy women with physiological pregnancy, in the absence of significant differences in TDV and AFAZ. 2. In pregnant women with DR in the third trimester, a statistically significant expansion of AFAZ with a decrease in TDV in the superficial plexus was revealed in comparison with pregnant women with DM and no DR. Key words: diabetes mellitus, diabetic retinopathy, optical coherence tomography in angiography mode, retinal blood flow.

scholarly journals Maternal and fetal outcomes of obese pregnant women: a prospective cohort study

2017 ◽  
Vol 6 (2) ◽  
pp. 725
Author(s):  
Jenniferbritto John ◽  
Mary Mahendran
Keyword(s):  
Diabetes Mellitus ◽  
Caesarean Section ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Maternal Obesity ◽  
Gestational Hypertension ◽  
Induction Of Labour ◽  
Control Group ◽  
Fetal Outcomes

Background: Obesity in Indian women had increased from 10.6% to 14.8% in India. Mothers who are overweight or obese during pregnancy and childbirth cause significant antenatal, intrapartum, postpartum and also neonatal complications. The present study aimed to explore various maternal and fetal outcomes influenced by maternal obesity. The objective was to find the effect of obesity on maternal and perinatal outcome among obese pregnant women compared to those of normal weight.Methods: The study was conducted in antenatal women attending antenatal outpatient department of CSI rainy multispecialty hospital located in North Chennai of South India. Consecutive sampling method was followed to include 50 cases and 50 controls. Analysis was done with IBM SPSS v.21.0. Chi square test was applied to find difference between proportions. For comparison of means independent t-test and ANOVA was applied. Pearson's correlation was done to find association between maternal BMI and birth weight.Results: Sixteen (32%) cases developed gestational diabetes mellitus during their antenatal period and 19 (38%) developed gestational hypertension. 10% underwent in emergency caesarean section and in 28% cases elective caesarean section was done. The proportion of cases who developed ante partum complications including gestational diabetes mellitus, gestational hypertension and preeclampsia were higher than in control groups (p value = 0.03,0.00,0.004 respectively). The need for induction of labour and caesarean section was found to be higher in cases than in controls (p = 0.014,0.03 respectively). Increased NICU admissions for stabilization of the newborn among cases was higher than control group (p = 0.012).Conclusions: It was clearly evident from the present study that maternal obesity had adverse maternal and fetal outcomes. Maternal obesity was strongly associated with antenatal complications like gestational diabetes mellitus, gestational hypertension, preeclampsia and increase in need for induction of labour and operative interference.

scholarly journals Serum magnesium and copper levels in Bangladeshi women with gestational diabetes mellitus

2017 ◽  
Vol 11 (1) ◽  
pp. 25-28
Author(s):  
Farzana Akonjee Mishu ◽  
MA Muttalib
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Medical College Hospital ◽  
Control Group ◽  
Oral Glucose ◽  
Third Trimester ◽  
College Hospital ◽  
Medical College

Background and objectives: Alteration of magnesium (Mg) and copper (Cu) concentrations in blood has been observed in normal pregnancy as well as in gestational diabetes mellitus (GDM). The present study was aimed to evaluate the serum Mg and Cu levels in Bangladeshi women with GDM in their second and third trimester of pregnancy.Methods: The study was conducted at Mymensingh Medical College Hospital from July 2013 to June 2014. Pregnant women, in their second and third trimester, attending the outpatient department of Obstetrics and Gynecology and the Department of Endocrinology of Mymensingh Medical College Hospital were enrolled by purposive sampling technique. GDM was diagnosed on the basis of oral glucose tolerance test (OGTT) as defined in WHO criteria 2013. Blood glucose was estimated by enzymatic GOD-PAP colorimetric method. The cut off value for fasting plasma glucose level was ?6.1 mmol/L or ?7.8 mmol/L 2 hours after glucose load. Serum Cu was estimated by 3, 5-DiBr-PAESA method and Mg by Xylidyl Blue-I Method as per manufacturer’s instruction.Results: A total of 172 pregnant women in their second and third trimester were enrolled. Out of 172 participants, 86 had GDM and 86 were normoglycemic (control). The mean age of GDM and control groups was 28.6±3.2 years and 27.3±3.1 years respectively. The BMI was 26.4±1.5 m/kg2 and 26.3±1.3 m/kg2. Serum Mg level was significantly low (p< 0.001) in 2nd and 3rd trimesters in GDM cases (1.39±0.26 mg/dl and 0.93±0.15 mg/dl) compared to control group (1.67±0.3 mg/dl and 1.67±0.31mg/dl). On the contrary, serum Cu levels in GDM cases were significantly (p<0.002) higher in both trimesters (224±333.8 ?g/dl and 243.91±6.89 ?g/dl) compared to those without GDM (220.1±7.6 ?g/dl and 234.9±4.6 ?g/dl). There was significant (p<0.001) increase of serum Cu levels in 3rd trimester compared to 2nd trimester in both GDM and non GDM cases.Conclusion: There was distinct alteration of serum Mg and Cu levels in GDM compared to normal pregnancy.IMC J Med Sci 2017; 11(1): 25-28

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