Pregnancies with major anomalies affecting multiple organ systems had significantly higher initial fasting serum glucose levels (166 +/- 64 mg/dL) compared with pregnancies in which one organ system was affected (141 +/- 55 mg/dL, P <.04) or no organ systems were affected (115 +/- 38 mg/dL, P <.0001).Ĭongenital anomalies in offspring of women with gestational and type 2 diabetes affect the same organ systems that have been previously described in pregnancies complicated by type 1 diabetes. There was no increased predominance of any specific organ system involvement seen with increasing fasting serum glucose levels in pregnancies with major congenital anomalies. Of those pregnancies with major anomalies, the most commonly affected organ systems were the cardiac (37.6%), musculoskeletal (14.7%), and central nervous systems (9.8%) and anomalies involving multiple organ systems (16%). The initial fasting serum glucose and glycosylated hemoglobin levels were significantly higher in pregnancies with major (n = 143) and minor (n = 112) anomalies and genetic syndromes (n = 9) compared with pregnancies with no anomalies (n = 3895).
In addition to maternal clinical and historical parameters, the initial fasting serum glucose either from the diagnostic glucose tolerance test (gestational diabetes mellitus) or at entry to prenatal care (type 2 diabetes) and the initial glycosylated hemoglobin before insulin therapy were examined for a relationship to anomalies. Major anomalies were further categorized by the number and type of affected organ systems. Anomalies were categorized as being absent, minor, major, genetic syndromes, or aneuploidies.
(Am J Obstet Gynecol 1996 175:982-4.We sought to determine the types of congenital anomalies affecting infants of women with gestational diabetes mellitus or type 2 diabetes and to examine the relationship between those malformation types and measures of initial glycemia of women at entry into prenatal care with type 2 diabetes or at time of diagnosis in women with gestational diabetes mellitus.Ī total of 4,180 pregnancies complicated by gestational diabetes mellitus (n = 3764) or type 2 diabetes (n = 416) that were delivered after 20 weeks of gestation were reviewed for the presence of congenital malformations diagnosed before hospital discharge. Thus this finding is not an appropriate indication for preterm delivery in the absence of other evidence of fetal compromise. CONCLUSION: Our data suggest that prenatal evidence of intestinal dilatation in fetuses with gastroschisis does not predict immediate neonatal outcome. Prenatal ultrasonographic examination failed to show significant bowel dilatation in either infant. Two newborns underwent bowel resection because of intestinal atresia.
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Fetuses with maximal bowel diameter of ≥17 mm did not have a longer time to full oral feeding, a longer initial hospital stay, or a greater need for bowel resection when compared with fetuses with a bowel diameter <17 mm. RESULTS: Twenty-one patients met the entry criteria during the study period. Neonatal outcomes of the two groups were compared. Patients were divided into two groups on the basis of the presence or absence of ultrasonographically measured fetal bowel diameter of ≥17 mm. STUDY DESIGN: A retrospective chart review was performed of all patients cared for at Los Angeles County/University of Southern California Women's and Children's Hospital with the prenatal diagnosis of gastroschisis over a 7-year period (1988 through 1995). OBJECTIVE: Our purpose was to evaluate the clinical significance of intestinal dilatation detected by prenatal ultrasonographic examination in fetuses with gastroschisis.