The "dangerous multipara": fact or fiction?

Article Abstract:

Grand multiparity may not confer risk aside from the risks incurred from increasing age. Labor complication rates believed to associate with grand multiparity were compared between a group of 382 women having a fifth baby or more and 382 age-matched women having a second, third, or fourth baby. Rates of placental abruption (the detachment of some or all of the placenta from the uterus before birth), dysfunctional labor, breech or other fetal malpresentation, postpartum hemorrhage, and shoulder dystocia (difficulty birthing the shoulder) were similar between the two groups. The overall incidence of labor complications was 33% among grand multiparas and 27% among the control population. Grand multiparas were more likely to have infants with birth weight of 4000 g or more and less likely to have forceps, vacuum extraction, or cesarean delivery. A large baby increased the risk of labor complications, but this was a confounding factor and was not related to prior number of births.

Risk factors, Pregnancy, Complications of, Pregnancy complications, Fetal macrosomia

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Postprandial versus preprandial blood glucose monitoring in women with gestational diabetes mellitus requiring insulin therapy

Article Abstract:

Regulating insulin therapy based on blood glucose levels after, rather than before, meals in women with gestational diabetes mellitus may improve the outcome of the pregnancy. Women with gestational diabetes have elevated blood glucose levels during pregnancy that often lead to excessive growth of the fetus and cesarean section. Among 66 women with gestational diabetes, 33 monitored their blood glucose levels after meals and 33 monitored these levels before meals. Women in both groups also monitored their fasting glucose levels. The women in the after-meal group took more insulin and had a greater decrease in glycosylated hemoglobin over their pregnancies. The average birth weight of babies was 3469 grams for women in after-meal group, and 3848 grams for women in the before-meal group. More babies in the before-meal group were born by cesarean section and had decreased blood sugar levels after birth.

Care and treatment, Methods, Diabetes in pregnancy, Gestational diabetes, Blood sugar monitoring, Blood glucose test

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Reduction of right atrial peak systolic velocity in growth-restricted discordant twins

Article Abstract:

Blood may flow more slowly through the heart of growth retarded twins than through the heart of normally growing cotwins during pregnancy. Researchers used ultrasound to analyze blood flow through the ventricles in 18 anatomically and genetically normal twin pairs where one twin was growing abnormally slowly compared with the other. Blood flow velocity was slower through the tricuspid valve in the slowly growing twin. This suggests that blood flow studies could help differentiate growth retardation due to insufficient placental circulation from other causes.

Blood flow, Measurement, Blood flow measurement, Fetus, Physiological aspects, Fetal growth retardation, Growth disorders, Twins

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