Antenatal diagnosis of sacral agenesis syndrome in a pregnancy complicated by diabetes mellitus

Article Abstract:

Congenital abnormalities have been observed in fetuses born to mothers with diabetes mellitus, a disorder of sugar intolerance. Although no one type of abnormality is found in fetuses born to diabetic mothers, sacral agenesis, the failure of all or part of the lower sacral area of the spine to form, is the most common type. A 24-year-old woman with severe diabetes was in her 25th week of pregnancy. Ultrasonographic evaluation (the use of high frequency sound to visualize internal structures) of the fetus visualized an absent lower spine. The anatomy of the fetus above the middle of the chest was normal. The size of the legs and feet were smaller than expected for the age of the fetus. The infant was delivered at 35 weeks when the mother developed a tender uterus and low grade fever. A male infant with the correct number of chromosomes was delivered. The infant was able to breathe normally but its abdomen was distended. Web-like skin attached the calves to the lower thighs. X-rays revealed complete absence of the vertebral bones below the seventh thoracic vertebrae. Although the infant's upper body appears to be growing normally, the lower body cannot move. An examination of the relationship between the degree of sugar intolerance and the development of fetal abnormalities was unrevealing. Ultrasonographic imaging of pregnancies complicated by insulin-dependent diabetes mellitus is essential. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Abnormalities, Fetus, Development and progression, Birth defects, Vertebrae, Prenatal ultrasonography, Ultrasonics in obstetrics

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Meconium aspiration syndrome: intrapartum and neonatal attributes

Article Abstract:

Meconium is the material in the fetal intestines produced during pregnancy, and is the first stool passed after a baby is born. Meconium passed before birth can indicate fetal distress; within the amniotic fluid of the uterus the fetus can inhale (aspirate) meconium. Aspirated meconium can block air passages, and cause breathing problems and pneumonia in the newborn. When meconium is detected in the amniotic fluid during labor or delivery, the infant's airway is suctioned at birth. Although suctioning reduces complications, some infants develop meconium aspiration syndrome. To identify newborns at risk for meconium aspiration syndrome, 238 infants delivered through meconium-stained amniotic fluid were evaluated. Twenty-two of these infants developed meconium aspiration syndrome; seven were severely ill. Characteristics of infants most likely to develop meconium aspiration syndrome were: rapid fetal heartbeat, the absence of accelerations on fetal heart monitoring during labor contractions, low pH of blood in the umbilical artery, low APGAR score (a score given to measure newborn well-being) and the presence of thick meconium. The use of this model correctly predicted half of the infants with meconium aspiration syndrome. Fetal heart monitoring is recommended in all cases of thick meconium staining, and infants at risk should be closely monitored for the development of meconium aspiration syndrome.

Causes of, Risk factors, Labor, Complicated, Labor complications, Meconium aspiration syndrome

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Gestational Diabetes Mellitus: Does it recur in subsequent pregnancy?

Article Abstract:

Gestational Diabetes Mellitus, a type of sugar intolerance found only during pregnancy, can greatly affect the health of both the mother and the fetus or newborn infant. The purpose of this study was to determine how often the patients diagnosed with gestational diabetes in their first pregnancy had the same complication of glucose intolerance in their next pregnancy. Of the 36 patients whose previous pregnancies complicated by gestational diabetes, 20 had the same diagnosis in their next pregnancy. The differences found in the two groups may result from either inaccurate Glucose Tolerance Test (GTT) results or chemical changes which protected the patient from subsequent diabetic pregnancies. Patients with more than one glucose intolerant pregnancy were found to be much heavier and delivered heavier infants, and they tended to become progressively heavier with each new pregnancy. This would put obese patients at a particularly high risk for gestational diabetes.

Research, Diagnosis, Demographic aspects, Diabetes, Diabetes mellitus, Obesity, Pregnancy, Complications of, Pregnancy complications, Carbohydrates

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