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class H Diabetes maternal mortality

H David McIntyre, Kristen S Gibbons, Vicki J Flenady, Leonie K Callaway
OBJECTIVES: To document temporal trends in maternal overweight and obesity in Australian women and to examine associations with pregnancy outcomes. DESIGN, SETTING AND PARTICIPANTS: Retrospective 12-year cohort study of 75 432 women with singleton pregnancies who had pre-pregnancy height and weight data available and who gave birth in a tertiary referral maternity hospital in Brisbane between January 1998 and December 2009. MAIN OUTCOME MEASURES: Maternal body mass index (BMI); prevalence of overweight and obesity, and pregnancy complications including hypertension, gestational diabetes, caesarean delivery, and perinatal morbidity and mortality...
February 20, 2012: Medical Journal of Australia
A Aberg, H Rydhström, B Källén, K Källén
OBJECTIVES: To analyze whether women with a diagnosis of gestational diabetes in the current pregnancy had an increased rate of stillbirths or of large for gestational age infants in previous pregnancies without an overtly present/diagnosed gestational diabetes. DESIGN: A case-control analysis with two controls for each case, matched for year of delivery, maternal age (5 year class), and parity. MATERIAL AND METHODS: All women with a diagnosis of gestational diabetes and delivered between 1987 and 1992 were identified from the Swedish Medical Birth Registry...
March 1997: Acta Obstetricia et Gynecologica Scandinavica
S W Aucott, T G Williams, R H Hertz, S C Kalhan
The effect of rigorous management of insulin-dependent diabetes mellitus (IDDM) during pregnancy on the perinatal outcome was assessed by comparing 78 prepartum gravid patients with IDDM managed prospectively with 78 matched controls. The diabetic women were treated with insulin by either infusion pump or split-dose therapy, with the goal of normalization of the fasting blood sugars and hemoglobin Hb A1c values. Differences in the perinatal outcome were evaluated by either chi-square or analysis of variance...
September 1994: Acta Diabetologica
X Pombar, H T Strassner, P C Fenner
BACKGROUND: Maternal and fetal mortality have been reported to be high in pregnant women with diabetes mellitus and ischemic heart disease. Review of the literature identified only two cases of pregnancy after coronary artery bypass surgery in diabetic patients. Because of limited case experience, there are no clear recommendations for counseling and managing such patients. CASE: We managed a pregnancy complicated by class H diabetes mellitus in which the patient had an earlier need for four-vessel coronary artery bypass surgery...
May 1995: Obstetrics and Gynecology
J L Ballard, J Holroyde, R C Tsang, G Chan, J M Sutherland, H C Knowles
Over a period of 23 years we accumulated data on 182 pregnant juvenile diabetic subjects during pregnancy, labor, and delivery. Diabetic subjects were evaluated generally after the first trimester of pregnancy. Data examined included diabetic class, maternal complications of pregnancy, and infant morbidity and mortality. Data were analyzed in two periods-before and after 1970. In the second period, maternal polyhydramnios and acidosis rates improved, neonatal problems of homeostasis did not change significantly, and combined fetal and neonatal losses fell from 34...
April 15, 1984: American Journal of Obstetrics and Gynecology
J P Lavin, D R Lovelace, M Miodovnik, H C Knowles, T P Barden
Clinical experience with 45 pregnancies in women with Class A diabetes and 62 pregnancies in women with insulin-requiring diabetes is described. The perinatal mortality rates were 0, 16.1, and 9.3, respectively, among the Class A, insulin-requiring, and total diabetic populations. Diabetic mothers experienced significantly higher prevalences of cesarean section and ketoacidosis than did the overall population. There were no other significant differences in maternal complications. Diabetic mothers demonstrated high rates of abnormal estriol levels and relatively low rates of positive contraction stress tests...
December 1, 1983: American Journal of Obstetrics and Gynecology
I S Mashini, H E Fadel, G H Nelson, H A Hadi
The management of 430 diabetic pregnancies is presented. Our protocol emphasized "tight" metabolic control and assessment of fetal well-being by antepartum fetal heart rate testings and estriol levels. Spontaneous labor was allowed in uncomplicated Class A diabetic patients. Labor in complicated cases and insulin-dependent diabetic pregnancies was induced after establishing fetal lung maturity, except when a maternal or fetal complication dictated otherwise. A significant drop in estriol was observed in 4% of Class A diabetic patients and 10...
December 1, 1985: American Journal of Obstetrics and Gynecology
H I Pirttiaho, A L Hartikainen-Sorri, P Kääpä, J M Kaila, R Puukka
Preservation of own insulin production (residual pancreatic beta-cell function) has been shown to have a beneficial effect on glycemic control in insulin-dependent diabetic subjects, and its total lack has been suggested to be an independent risk factor during diabetic pregnancy. We studied the influence of residual beta-cell activity on the glucose control and the outcome of pregnancy in 29 diabetic women by sequentially measuring gestational postprandial plasma C-peptide (CPR) levels, diurnal blood glucose curves and blood glycosylated hemoglobin (Hb A1c) and by analyzing the morbidity and mortality of the offsprings...
1987: Journal of Perinatal Medicine
W Burkart, J P Hanker, H P Schneider
From 1978 to 1986 a total of 189 pregnant diabetic women gave birth at our hospital. In this randomized prospective study the influence of maternal diabetes treatment in normoglycemic patients, continuous subcutaneous insulin infusion (n = 48) versus intensified conventional treatment (n = 41), is evaluated. These two groups of patients are further compared to patients (n = 28) who underwent conventional diabetes treatment during pregnancy. It can be shown from our data that the rate of complications such as preeclampsia, intrauterine growth retardation, premature labor and premature delivery can be reduced by intensified conventional and insulin pump treatment as compared to conventionally treated patients with late onset of pregnancy care...
1988: Gynecologic and Obstetric Investigation
J Schwingshandl, H Rosegger, J Haas, H M Hofmann, P A Weiss
We report on 143 newborns of mothers with insulin dependent diabetes during pregnancy. The mean birth weight was 3.091 (+/- 619) g at a mean gestational age of 38.4 (+/- 2) weeks. Neonatal morbidity was associated with the disease class, insulin levels in the amniotic fluid, urine and cord blood; and especially persistent fetal hyperinsulinism as indicated by repeatedly high amniotic fluid insulin levels during pregnancy. One infant died (neonatal mortality 0.69%) of a severe cardiac malformation combined with a caudal regression syndrome...
February 1989: Monatsschrift Kinderheilkunde: Organ der Deutschen Gesellschaft Für Kinderheilkunde
S G Gabbe, J H Mestman, R K Freeman, U T Goebelsmann, R I Lowensohn, D Nochimson, C Cetrulo, E J Quilligan
During the period 1971 to 1975, 260 women with diabetes mellitus, Classes B through R, were delivered of their infants at Los Angeles County Women's Hospital. The plan of patient management included frequent clinic visits and hospitalization to assure good control. A program of intensive antepartum fetal surveillance was begun at 34 weeks' gestation, with the use of daily 24 hour urinary estriol determinations and a weekly contraction stress test (CST). A lecithin/sphingomyelin ratio was evaluated for all patients before elective delivery...
December 1, 1977: American Journal of Obstetrics and Gynecology
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