Premature ovarian insufficiency: the context of long-term effects.

PURPOSE: Premature ovarian insufficiency (POI) is defined as the cessation of the ovarian function before the age of 40 years. POI aetiology may be related to iatrogenic or endogenous factors and in many cases remains unclear. The aim of this review was to characterize the long-term consequences of POI. METHODS: The available literature regarding the long-term consequences of POI from MEDLINE has been reviewed. RESULTS: Lack of ovarian steroids synthesis has serious consequences for women's health. The short-term effects are similar to spontaneous menopause and refer mainly to the climacteric syndrome. In a longer perspective, POI affects a variety of aspects. It obviously and drastically reduces the chances for spontaneous pregnancies. Oestrogen loss leads also to urogenital atrophy. The most common urogenital symptoms include vaginal dryness, vaginal irritation and itching. The urogenital atrophy and hypoestrogenism interferes also with sexual functioning. Patients with POI are threatened by a decrease in bone mineral density (BMD). POI women also experience psychological distress and some studies have shown an increased risk of neurodegenerating diseases. Overall, POI women have a shortened life expectancy, mainly due to cardiovascular disease. Some studies have reported a reduced risk of breast cancer in this group of patients. CONCLUSIONS: In conclusion there are several well-characterized health risks in POI women. With every patient, an individualized approach is required to properly recognize and prevent these risks.

Automatic detection of ultrasonic Doppler signal episodes resulting from fetal breathing movements.

A method for automatic detection of fetal breathing movements has been proposed, based on the time-frequency structure of the corresponding continuous wave ultrasonic Doppler signals. The method uses spectral analysis of the envelope of the directional Doppler signal and cross-correlation analysis of both directional envelopes. Detection rule comprises the following criteria: presence of the peak in the envelope spectrum and of the adequate signal level in the frequency range corresponding to the fetal breathing rhythm, the peak value and the position limits of the peak of the cross-correlation coefficient of the both directional envelopes. The effect of the criteria setting on the rule performance and the tradeoff between the specificity and sensitivity was investigated. The rule is most sensitive to the threshold value of the cross-correlation coefficient of the envelopes. The limits of the position of this peak are crucial for the distinction between the breathing episodes and hiccups. The optimal settings of the criteria, resulting in average sensitivity and specificity exceeding, respectively, 0.70 and 0.80, are proposed.

Alpha-hydroxybutyrate dehydrogenase activity in intrahepatic cholestasis of pregnancy.

OBJECTIVES: Intrahepatic cholestasis of pregnancy (ICP) is associated with increased perinatal mortality and morbidity. Alpha-hydroxybutyrate dehydrogenase (alpha-HBDH) is an enzyme that originates in the cytoplasm of hepatocytes and can be detected in the serum. The aim of this study was to determine the characteristics of alpha-HBDH activity in ICP. METHODS: The study included 100 women in their third trimester of pregnancy, 58 of whom had ICP (the study group) and 42 were healthy (the control group); another group, 26 nonpregnant women, was also analyzed to follow changes in alpha-HBDH activity during pregnancy. The concentrations or activity of fractionated bilirubin; bile acids; total alkaline phosphatase; alanine and aspartate aminotransferases; total high-density and low-density lipoprotein cholesterol; triglycerides; total protein; and alpha-HBDH were assessed. RESULTS: The activity of serum alpha-HBDH is increased during the third trimester of pregnancies complicated by ICP, and it correlates positively with total and direct bilirubin concentration and total alkaline phosphatase activity. CONCLUSIONS: Alpha-hydroxybutyrate dehydrogenase serum activity seems to be another biochemical parameter useful in the assessment of ICP severity.

What we can really expect from telemedicine in intensive diabetes treatment: results from 3-year study on type 1 pregnant diabetic women.

Existing standards of the management of the diabetic patients are not efficient enough, and further improvement is needed. The major objective of this paper is to present and discuss the therapeutic effectiveness of an intensive care telematic system designed and applied for intensive treatment of pregnant type 1 diabetic women. The developed system operates automatically, every night transferring all the data recorded during the day in the patient's glucometer memory to a central clinical unit. In order to assess the efficiency of the designed and developed system, a 3-year randomized prospective clinical trial was conducted, using the study group and the control group, each consisting of 15 pregnant type 1 diabetic women. All patients were treated by the same diabetologist. In the presented analysis, two indices calculated weekly were used for the assessment of glycemic control: MBG represents mean blood glucose level, and the universal J-index is sensitive to the glycemic level and glycemic variations. The most important results from the study concern: (a) better glycemic control in the study group in comparison with the control group during the course of treatment, as assessed by the average differences of the MBG and J indices calculated weekly (n = 24) (deltaMBG = -3.2 +/- 4.3 mg/dL, p = 0.0016, deltaJ = -1.4 +/- 2.3, p = 0.0065); (b) much more similar results in glycemic control among members of the study group compared to each other, than among members of the control group compared to each other, as indicated by significantly lower variations of the applied glycemic control indices (SDMBG: 11.9 vs. 18.7 mg/dL, p = 0.0498; SDJ: 6.5 vs. 10.9, p = 0.0318); (c) the observed tendency of a better glycemic control for patients with a lower level of intelligence (IQ < 100) supported by the telematic system in comparison with all other assessed groups of patients. The last result was not statistically significant (p > 0.05). This telematic intensive care system improved the effectiveness of diabetes treatment during pregnancy. It also allows the diabetologist's strategy to be much more precise than if it were conducted without telematic support. This telematic system is inexpensive and simple in use.

The biochemical functions of the renal tubules and glomeruli in the course of intrahepatic cholestasis in pregnancy.

Biochemical functions of kidney glomeruli and tubules were estimated in pregnancy complicated by cholestasis. The investigated group consisted of 72 women with pregnancy complicated by cholestasis and 30 healthy pregnant patients as a control group. Biochemical assays were performed for the deamination of amino acids, carbonic acid dissociation and creatinine metabolism. Statistical analysis was carried out using the t-test and P<0.05 was considered to be significant. In diurnal urine samples collected from pregnant patients with cholestasis, decreased concentrations of NH4+ (42.0+/-8.9 versus 50.3+/-7.6 mmol/24 h), H+ (19.0+/-7.0 versus 25.0+/-5.0 mmol/24 h), creatinine (1.15+/-0.2 versus 1.43+/-0.3 mmol/24 h) as well as lower levels of creatinine clearance (89.0+/-23.0 versus 135.0+/-30.0 ml/min) and normal levels of potassium and sodium were observed. Serum creatinine and uric acid concentrations were elevated (86.6+/-7.07 versus 66.3+/-4.42 micromol/l and 32.1+/-8.3 versus 19.0+/-3.57 micromol/l). Diurnal urine volume was lower in patients with cholestasis than in the control group (995+/-313 versus 1264+/-426 ml/24 h). Disturbances of biochemical functions of kidney glomeruli and tubules, regarding creatinine metabolism and deamination of amino acids, and dissociation of carbonic acid, were seen in patients with cholestasis during pregnancy.

Calcium-phosphorus-magnesium homeostasis in women with threatened preterm delivery.

OBJECTIVE: The effect of threatened preterm delivery on calcium, phosphorus, magnesium homeostasis in the third trimester of pregnancy was investigated. METHODS: Serum concentrations of total and ionized calcium, inorganic phosphorus, magnesium, total protein, albumin, total estrogens and human placental lactogen were determined in women with threatened preterm delivery at 29-36 weeks of gestation (the studied group) and in women with uncomplicated pregnancy of the same duration (the control group). Additionally, activities of total alkaline phosphatase and heat-stable alkaline phosphatase fraction were measured. RESULTS: Patients of the studied group compared to the control group showed decreased concentration of total calcium (2.17 +/- 0.09 vs. 2.28 +/- 0.13 mmol/l, P < 0.0005), inorganic phosphorus (1.13 /- 0.27 vs. 1.32 +/- 0.23 mmol/l, P < 0.001) and magnesium (0.64 +/- 0.07 vs. 0.70 +/- 0.10 mmol/l, P < 0.003); they also demonstrated decreased activity of total alkaline phosphatase (70.8 +/- 23.2 vs. 81.9 +/- 14.9 IU/l, P < 0.01) and its heat-stable fraction (30.2 +/- 15.6 vs. 59.6 +/- 14.9 IU/l, P < 0.001). In the studied group no difference was found in concentrations of investigated ions and enzymes between women who delivered at term and women who delivered prematurely. Patients with threatened preterm delivery showed serum deficiency of total calcium, phosphorus and magnesium which might be related to premature uterine contractility but does not predict premature labor by week 36 of gestation (66% of patients delivered at term). CONCLUSION: The deficiency of minerals and lowered activity of total alkaline phosphatase is observed in women with threatened preterm delivery. Laboratory tests of calcium-phosphorus-magnesium homeostatsis have limited predictive value in regard to the term of delivery in women with threatened preterm delivery.

Calcium-phosphorus-magnesium homeostasis in pregnant women after renal transplantation.

OBJECTIVE: The aim of the study was the assessment of calcium-phosphorus-magnesium homeostasis in pregnant women after renal transplantation. METHODS: The study covered 64 pregnant women in the third trimester of gestation including: 33 women after renal transplantation (the study group) and 31 healthy pregnant women (the control group). Women from both groups were at the similar age: 30.8+/-4.7 vs. 31.3+/-5.0 years (NS) and at the same gestational age 34.8+/-2.4 vs. 35.3+/-2.6 weeks (NS). The mean body mass index (BMI) in the women from the study group before pregnancy was 21.49+/-2.81 vs. 22.1+/-3.02 in the control group (NS), BMI before delivery was 25.43+/-3.05 vs. 26.0+/-3.35 (NS), the percentage of the BMI increase during pregnancy was 18.7+/-7.68 vs. 17.65+/-7.13 (NS) and BMI increase during gestation was 3.93+/-1.56 vs. 3.90+/-1.54, respectively (NS). Arterial blood pressure at the time of blood samples collection for biochemical tests was 151.4+/-26.8/92.5+/-16.9 in women from the study group comparing to 115.0+/-6.0/68.0+/-7.0 mmHg (P<0.001) in the patients from the control group. The maximal blood pressure during pregnancy was 169.2+/-20.7/102.7+/-14.0 vs. 118.0+/-7.0/70.0+/-8.0 mmHg (P<0.001), respectively. We estimated serum levels of: total Ca, ionized Ca(2+), inorganic phosphorus (P(i)), Mg, total protein, albumin and blood morphology. Moreover, urine levels of Ca, P(i), Mg and protein were assessed. RESULTS: The pregnant women after renal transplantation presented increases in serum concentrations of total Ca (2.54+/-0.20 vs. 2.16+/-0.10 mmol/l; P<0.001) and ionized Ca(2+) (1.322+/-0.104 vs. 1.12+/-0.07 mmol/l; P<0.001) and the decrease in P(i) level (1.013+/-0.211 vs. 1.10+/-0.16 mmol/l; P<0.05), total protein (59.3+/-7.0 vs. 65+/-5 g/l; P<0.001) and albumin (461.6+/-65.65 vs. 493.2+/-59 micromol/l; P<0.05). Moreover, in the study group drop in red blood cells count to 3.71+/-0.56 vs. 4.01+/-0.35 x 10(12)/l (P<0.02) in the control group was detected. Despite increased volume of 24-h urine collection in the kidney recipients we observed significantly decreased urine 24-h calcium excretion 2.47+/-0.92 vs. 6.72+/-3.49 mmol (P<0.001) and simultaneous increase in urine Mg excretion 3.422+/-1.025 vs. 2.18+/-0.52 mmol/24 h (P<0.001). There was no difference in urine 24-h P(i) excretion between the study and the control group. The pregnant renal transplant recipients presented proteinuria of 1.19+/-1.9 g/24 h. CONCLUSIONS: Women after kidney grafting present vital aberrations in calcium-phosphorus-magnesium homeostasis during pregnancy. The most significant changes are associated with calcium metabolism (high increase in serum Ca levels and impairment of renal elimination of calcium). The observed changes may be influenced by the doses of immunosuppressive agents and disturbed renal function.

Second trimester calcium-phosphorus-magnesium homeostasis in women with threatened preterm delivery.

OBJECTIVE: The effect of threatened preterm delivery on calcium, phosphorus, magnesium homeostasis in the second trimester of pregnancy was investigated. METHODS: Serum concentrations of total and ionized calcium, inorganic phosphorus, magnesium, total protein, albumin, total estrogens and human placental lactogen were determined in women with threatened preterm delivery at 23-28 weeks of gestation (the studied group) and in women with uncomplicated pregnancy of the same duration (the control group). Additionally activities of total alkaline phosphatase and heat-stable alkaline phosphatase fraction were measured. RESULTS: Patients of the studied group compared to the control group showed decreased concentration of total calcium (2.15 +/- 0.073 vs. 2.25 +/- 0.11 mmol/l, P < 0.001), inorganic phosphorus (1.21 +/- 0.26 vs. 1.34 +/- 0.22 mmol/l, P < 0.01) and magnesium (0.63 +/- 0.053 vs. 0.71 +/- 0.12 mmol/l, P < 0.001), total protein (64.0 +/- 5.4 vs. 68.6 + 1.0 g/l, P < 0.001), albumin (546.3 +/- 55.1 vs. 579.6 +/- 49.3 micromol/l, P < 0.003) and placental lactogen (3664 +/- 1806 vs. 4651 +/- 1858 ng/ml, P < 0.02); they also demonstrated decreased activity of total alkaline phosphatase (42.17 +/- 16.99 vs. 50.66 +/- 6.56 IU/l, P < 0.001) and its heat stable fraction (22.65 +/- 7.89 vs. 31.89 +/- 9.09 IU/l, P < 0.001). Patients of the studied group showed normal values of ionized calcium and total estrogens. CONCLUSIONS: Premature uterine contractility in women in the second trimester is accompanied by lowered serum concentrations of total calcium, inorganic phosphorus, magnesium, total protein and albumin. There is also decreased activity of total alkaline phosphatase, its heat-stable fraction and placental lactogen which may have diagnostic value. Premature uterine contractility in women in the second trimester may be related to the disturbances of calcium-phosphorus-magnesium homeostasis and calcium supplementation should be considered.

Teletransmission system supporting intensive insulin treatment of out-clinic type 1 diabetic pregnant women. Technical assessment during 3 years' application.

A telematic system supporting intensive insulin treatment of pregnant type 1 diabetic out-clinic patients was implemented and technical efficiency of the system was evaluated over long-term ambulatory application. The system consists of a patient teletransmission module (PTM) and a central clinical control unit (CCU). The PTM contains a one-box blood glucose meter and electronic logbook, a modem and a dial-up or cellular phone set. The CCU consists of a PC computer with a modem and DIAPRET - an original program designed to monitor the intensive insulin treatment. The system was installed in the Clinic of Gastroenterology and Metabolic Disease, MA Warsaw and was tested for 166 +/- 24 days on 15 pregnant type 1 diabetic women. Telemonitoring of the patient data was done automatically. No major technical problems with proper operation or handling of the system was noted. Total effectiveness was 69.3 +/- 13.0% and technical effectiveness 91.5 +/- 6.1%. The efficacy of the system was not significantly influenced by patient intelligence level, education level or place of residence (p < 0.05). Significant improvement of metabolic control was noted during application of the system. In conclusion, the telematic system we developed and implemented should have a positive influence on the quality of diabetes treatment during pregnancy.

[Neonatal outcome depending on the mode of delivery and fetal presentation in twin gestation]. / Stan noworodka a polozenie plodów i metoda porodu w ciazy blizniaczej.

A retrospective analysis of 301 twin deliveries managed at The Second Department of Obstetrics and Gynecology, Warsaw Medical Academy, from January 1, 1986 to December 31, 1995 was undertaken in order to investigate the impact of the mode of delivery and twin presentation on neonatal outcome. Vertex presentation of both twins was the most common with an incidence of 47.5% followed by vertex-non-vertex (27.6%) and nonvertex presentation of the first twin (24.9%). 186 (61.8%) patients delivered vaginally, while 115 (38.2%) women underwent caesarean section including 6 operations performed after the vaginal delivery of the first twin. In vertex presentation of the first twin and breech second twin there was no significant difference in neonatal outcome measured by 5-minute Apgar score and birth trauma incidence between second twins delivered vaginally and second twins delivered by caesarean section. Vaginal delivery with internal podalic version of the second twin in vertex-transverse presentations was related to increased risk of lower 5-minute Apgar score and increased risk of birth trauma occurrence compared to caesarean section. Time interval between vaginal delivery of twins had no significant impact on neonatal outcome.

[Initial analysis of chocolate cysts operated on by laparoscopy]. / Wstepna analiza torbieli czekoladowych operowanych laparoskopowo.

53 women with an ovarian chocolate cyst were operated in a laparoscopy. A histopathological examination showed 60.4% of endometriomas and 39.6% of hemorrhagic lutein cysts. The average age of patients with endometriomas was 33.9 while of the ones with hemorrhagic lutein cysts was 28.6. The operated patients, who were under 35 years old, could be divided into halves, one half of them had endometriomas while the other half had hemorrhagic lutein cysts. However, endometriomas appeared significantly more often in the group of operated patients who were older than 35 years old.

[Pregnancy in women with diabetes complicated by nephropathy and proliferative retinopathy]. / Ciaza u kobiet chorych na cukrzyce powiklana nefropatia i retinopatia proliferacyjna.

Nephropathy and proliferative retinopathy are widely known as the most serious complications of diabetes. In the paper the analysis of the course of pregnancy, labour and neonatal complications among mothers with White class F, R, FR and T was made. The study group consisted of 44 patients. Primary hypertension was observed in 17 (38.6%) patients. The percentage of complications both maternal and neonatal was very high. Among maternal complications were pregnancy induced hypertension (43.2%), urinary tract infections (36%), anaemia (22.7%), threatened preterm labor (13.6%). Nearly 50% of patients has diurnal proteinuria in nearly 50% of patients exceed 3 g. In the opinion of the authors there is a strong need to establish the national supraregional centers designed specially to deal with the problems of pregnant women with diabetic nephropathy and retinopathy.

[Homeostasis of calcium-phosphorus-magnesium in women with pregnancy induced hypertension]. / Homeostaza wapniowo-fosforanowo-magnezowa u kobiet z nadcisnieniem tetniczym krwi indukowanym przez ciaze.

Study group consisted of 63 women in the III trimester of pregnancy (gestational age 29-40 weeks). 32 subjects with PIH (investigated group) were compared to control group consisted of 30 healthy patients with uneventful course of gestation. Women with PIH had no proteinuria nor oedema, their mean blood pressure remained at the level of 161 +/- 16.7/98 +/- 12.8 mm Hg. Concentration of calcium, phosphorus and magnesium in serum blood and urine were determined. It was stated that due to renal impairment observed during PIH, calcium urine excretion and calcium concentration in blood serum are decreased while serum inorganic phosphorus levels are increased. No changes in magnesium and ionised calcium homeostasis were seen in the course of PIH.

[Lipid metabolism in women with threatened abortion]. / Metabolizm lipidów u kobiet z poronieniem zagrazajacym.

The study group consisted of 130 subjects: 50 healthy nonpregnant, 35 healthy women in the I trimester of gestation (gestational age 6-15 weeks) and 45 patients with symptoms of threatened abortion (the same gestational age). In the latter group pain and bleeding ceased after hormonal treatment and spasmolytic drugs. Serum blood concentration of following compounds were determined: total lipids, LDL fraction, total cholesterol, phospholipids, triglycerides, HDL and LDL cholesterol fractions. Threatened abortion had changed lipids profile; diminished concentrations of LDL fraction, total cholesterol, LDL cholesterol fraction and phospholipids were observed. Levels of total lipids, phospholipids and triglycerides++ in blood serum of healthy pregnant women in the I trimester of gestation were higher than in nonpregnant women.

[The effect of total estrogens and lactogen hormone on lipid metabolism in women during normal pregnancy]. / Wplyw estrogenów calkowitych i hormonu laktogennego na metabolizm lipidów u kobiet w prawidlowej ciazy.

Lipids parameters and total oestrogen and HPL levels were estimated in blood serum. Investigated group consisted of 45 women with uneventful course of pregnancy. All pregnant women were in the gestational age between 29 and 40 weeks. This is positive correlation increased concentration of total lipids, LDL fraction, phospholipids, triglycerids and raising of total oestrogens. High concentration of total cholesterol, LDL cholesterol fraction and phospholipids were observed at the same time as increased levels of HPL. We suggest that multivariative hormonal changes during uncomplicated course of gestation could be the cause of modificated lipids profile.

[Bile acids in blood serum of women during normal pregnancy, early puerperium and in the neonate]. / Kwasy zólciowe w surowicy krwi kobiet w przebiegu prawidlowej ciazy, u poloznic oraz u noworodków.

Total bile acids in serum blood samples from 325 subjects were estimated. Study group consisted of 50 nonpregnant women, 40-in the I trimester, 50-in the II and 100-in the III trimester of gestation, 55 patients in the third day of puerperium and 30 newborn infants (cord serum). All women were healthy, their age varied between 20 and 36 years. Children were mature, born in good condition (Apgar score > 8 points). Bile acids concentration were determined using enzymatic method with reagent kits by Nycomed Pharme, Norway. In the course of pregnancy continuous increase of investigated compounds was observed. The concentration of bile acids in puerperium was lower than in the III trimester of pregnancy and equal to that determined in cord serum. Authors conclude that during normal, uneventful course of gestation symptomless, benign intrahepatic cholestasis occurs.

[The influence of chosen hormones on lipids and its correlation during normal pregnancy]. / Wplyw niektórych hormonów na lipidy oraz ich korelacja podczas przebiegu prawidlowej ciazy.

OBJECTIVES: Lipids and hormones levels in nonpregnant and pregnant with uneventful gestation (from I, II, III trimester) were estimated and its correlation was evaluated. METHODS: The study group consisted of 219 women: 49 nonpregnant and 170 pregnant women (35 in I trimester, 35 in II and 100 in III trimester of gestation). All subjects were healthy. Following parameters were measured in blood serum: total lipids, LDL total fraction, (beta-lipoproteids), cholesterol both total and free, HDL cholesterol, LDL cholesterol. Percentage of free cholesterol contained on total cholesterol was evaluated. HPL and estrogens levels were estimated. RESULTS: Serum levels of total lipids, phosphlipids, triglicerides, total fraction of LDL and its contains of cholesterol increase with gestational age (p < 0.001). During pregnancy positive correlation between estrogens, HPL and triglycerides was also observed (p < 0.001). Additionally in II trimester positive correlation of total cholesterol, phospholipids and HPL was noted (respectively r = 0.469 p < 0.001 and r = 0.452 p < 0.01). CONCLUSIONS: In case of women with uneventful pregnancy positive correlation between estrogens and total lipids, total fractions LDL and triglycerides was stated. Also positive correlation among lipids parameters and HPL concentration was noted. No correlation between HPL and free cholesterol, LDL, HDL cholesterol nor between estrogens and total cholesterol, free cholesterol and LDL cholesterol was found. Lipids status in case of nonpregnant women is multihormonaly influenced.

[Various biochemical parameters of renal tubular function in patients with type I diabetes in the third trimester of pregnancy]. / Niektóre parametry biochemiczne funkcji kanalików nerkowych u chorych na cukrzyce typu I w III trymestrze ciazy.

The studied group comprised 47 women in the 3rd trimester of pregnancy (29-40 weeks), including 17 with type I diabetes (study group) and 30 healthy women (control group). In the study group in one case diabetes was diagnosed during pregnancy and treated with diet only, in the remaining 16 pregnant women the mean diabetes duration was 6.2 years and the mean daily insulin dose was 70 u. According to White's classification one patient was in class A, 10 in class B and 6 in class C. In all cases renal function was normal, with normal blood values of creatinine, urea, electrolytes, uric acid, protein and acid-base equilibrium. Endogenous creatinine clearance was also normal. The studied biochemical parameters of renal tubular function included: 1) deamination of amino acids--with measurement of ammonium ion (NH4+) excretion with urine, 2) carbonic acid metabolism--with determination of urinary excretion of hydrogen ions (H+), 3) urinary excretion of sodium (Na+) and potassium (K+) ions. Besides that 24-hour urine was always measured. The studied women were similarly hydrated (standard diet, fluid balance control). The results were subjected to statistical analysis. In women with type I diabetes the volume of 24-hour urine was increased, although it fell within the normal range, urinary excretion of Na+ and K+ was raised. No change was found in amino-acid deamination an carbonic acid metabolism since the excretion of NH4+ and H+ was normal.

[Results of screening tests for gestational diabetes mellitus at Medical University in Warsaw]. / Badania przesiewowe w kierunku rozpoznawania cukrzycy ciezarnych na materiale I i II Kliniki Poloznictwa i Ginekologii Akademii Medycznej w Warszawie.

Our purpose was to determine the incidence of screening for gestational diabetes among the population of women delivering at I and II Departments of the First Faculty of Medical University in Warsaw. A retrospective review of 647 pregnancies was performed. The incidence of gestational diabetes mellitus screening was determined and the rate of occurrence of GDM analyzed. 310 (48%) pregnancies were screened for gestational diabetes mellitus with a 1-hour, 50 gm oral glucose challenge test. 49 (16.07%) of the screens had positive results at a plasma glucose level of > 139 mg/dl. Two-hour 75 gm oral glucose tolerance tests (according to the 1994 World Health Organization panel recommendations) were performed on screen-positive women, eleven of whom (22.45%) were diagnosed with gestational diabetes mellitus. Despite of positive oral 50 gm glucose test, (plasma glucose level 140-179 mg/l) 15 women (30%) haven't had the 75 gm oral glucose test. The incidence of GDM among analyzed population is 4% and when GDM screening is carried out, exceeds 7%. Early gestational glucose screening, if performed, may be beneficial in detecting gestational diabetes. Consideration should be given to fulfill it more frequently and for sure, repeat glucose testing in patients with positive one-hour screening tests.

[Risk factors for gestational diabetes mellitus and results of glucose tolerance tests]. / Czynniki ryzyka cukrzycy ciazowej a wyniki testów obciazenia glukoza.

The authors made an effort to verify the connection between the presence of risk factors for GDM and results of screening and diagnostic tests. Study group consisted 302 patients. Gestational diabetes was more frequently diagnosed when an excessive maternal weight and family history of diabetes occurred. Among women with gestational diabetes recognised on the basis of the tests results (screening or diagnostic), 1/3 of patients had no evidence of any risk factor. There is no correlation between the number of risk factors and the occurrence of gestational diabetes. The risk factors were present in half of the investigated patients.