Prophylactic insulin in the management of gestational diabetes

Article Abstract:

Gestational diabetes is a complication of pregnancy characterized by high blood sugars that result from an inadequate ability to metabolize glucose. Mothers with gestational diabetes often deliver large infants, which can contribute to a difficult and traumatic labor and delivery. Gestational diabetes is treated with diet therapy, insulin therapy or both. To see if the diabetic diet, or diet and insulin combined, reduces maternal and fetal complications, 95 gestational diabetics were studied. Fifty women followed the standard diet therapy alone, while 45 women followed combined diet and prophylactic insulin therapy (20 units NPH and 10 units regular insulin). Sixty-eight women were successfully treated for their high blood sugars and were followed for six weeks or more. Compared with the diet-only group, the insulin-treated women had a lower rate of excessively large (macrosomic) infants, and average birth weight was lower. Of the women weighing less than 200 pounds at delivery, those treated with insulin had infants of lower birth weight (average weight 3,047 grams) than the group treated with diet alone (average weight 3,324 grams). Among women weighing over 200 pounds, average infant birth weights were 3,397 grams for the insulin group and 4,060 grams for the diet therapy group. None of the women under 200 pounds who achieved good blood glucose control delivered an infant weighing more than 8.8 pounds (4,000 grams). Women not accomplishing glucose control, with either diet or insulin and diet combined, had a 30 percent higher risk for excessive fetal size. Although prophylactic insulin therapy does not guarantee adequate glucose control in gestational diabetes, it is useful in reducing the risk of an excessively large infant, particularly in overweight women. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Physiological aspects, Drug therapy, Birth weight, Diabetes in pregnancy, Gestational diabetes, Diet therapy, Insulin, Fetal macrosomia

---

Cerebral palsy and intrapartum fetal monitoring

Article Abstract:

Years of monitoring fetal heart rates during labor have failed to reduce the incidence of cerebral palsy. Electronic continuous fetal monitoring was thought to detect heart rate abnormalities that signalled fetal distress. Performing an immediate cesarean section might prevent death or reduce permanent brain damage. However, the rate of 2 cerebral palsy cases per 1,000 term infants remains unchanged, regardless of intensive monitoring practices during labor. Heart rate abnormalities probably have been established earlier in the pregnancy rather than during labor. A 1996 study confirms the vague link between abnormal heart rate patterns and the risk of cerebral palsy. What causes 70% of all cerebral palsy cases remains unknown, while 10% to 20% of these cases may be related to events during delivery. A small number of factors, an estimated 10%, contributes to the disease after birth.

Editorial, Measurement, Risk factors, Cerebral palsy, Fetal distress, Fetal heart rate monitoring, Electronic fetal monitoring, Prenatal influences

---

Similar abstracts:

• Abstracts: The influence of birth weight on labor in nulliparas. Prediction of estimated fetal weight in extremely low birth weight neonates (500 -1,000 g)
• Abstracts: Use of centrally acting sympatholytic agents in the management of hypertension. Rapid reduction of sever asymptomatic hypertension: a prospective, controlled trial
• Abstracts: Prediction of glucose response to weight loss in patients with non-insulin-dependent diabetes mellitus. Impact of glucose self-monitoring on glycohemoglobin values in a veteran population
• Abstracts: The role of azalide antibiotics in the treatment of chlamydia
• Abstracts: Reported practices of pediatric residents in the management of attention-deficit hyperactivity disorder. New York regulation of residents' working conditions: 1 year's experience

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.