Influence of gestational diabetes in twin pregnancy on the condition of newborns and early neonatal complications.

OBJECTIVES: Diabetes mellitus is the most common metabolic complication in pregnancy and increasing worldwide. In Europe, it occurs in 3-5% of pregnant women. The rate of twin pregnancy has been increased similarly to gestational diabetes mellitus (GDM). Twin pregnancy is associated with a higher complication rate compared to singleton pregnancy. The growing prevalence of GDM and twin pregnancy has given rise to their increasing concurrent presentation. MATERIAL AND METHODS: The retrospective analysis included 212 twin-pregnant patients. The analysis excluded cases of miscarriage and early fetal death in the first trimester of pregnancy. The influence of GDM on the condition of newborns and mothers after delivery was analyzed. For statistical analysis R 3.6.2 software was used. RESULTS: No statistically significant relationship between GDM and Non-GDM group and periparturient complications was found. Birth weight was significantly higher in the GDM G2 group. Apgar Score was the lowest in the GDM G1 group. In the group of larger newborns of the GDMG1 group respiratory distress syndrome (RDS) , a higher incidence of second-degree intracranial bleeding and grade II of preterm retinopathy were observed. There was no statistically significant relationship between GDM G1, GDM G2 and other neonatal complications. CONCLUSIONS: In summary, our results indicate that GDM in twin pregnancy does not increase the risk of cesarean section but increases some neonatal complications. In conclusion women with twin pregnancies complicated by GDM require specialist care during pregnancy and childbirth should take place in a third-level reference center.

The role of individual blood flow parameters through ductus venosus in the first and second trimesters of pregnancy in predicting the condition of the fetus and newborn.

OBJECTIVES: To predict fetal and neonatal outcome during pregnancy based on detailed analysis of ductus venosus blood flow velocities in first and second-trimester fetuses. MATERIAL AND METHODS: A retrospective analysis was made in 680 patients with single pregnancies in years 2015 and 2016. The following ductus venosus blood flow velocities in first and second-trimester were analyzed: S-wave velocity, D-wave velocity, a-wave velocity, Tmax velocity, PIV. Results were divided into sub-groups with reduced value, normal value and increased value and compared with fetal and neonatal condition. RESULTS: The relationship between the increased PIV value in the first trimester of pregnancy and an increased risk of chromosomal aberrations was observed, whereas the increased DV PI value in the second trimester of pregnancy with reduced A -wave were associated with a higher incidence of FGR. No correlation between the remaining DV blood flow velocities in the first and second trimester of pregnancy and the more frequent occurrence of fetal and neonatal complications has been confirmed. CONCLUSIONS: The increased DV PIV is a good prognostic tool for the detection of chromosomal aberrations in first trimester of pregnancy. In the second trimester, the increased DV PIV and the reduced A- wave velocity correlate with the fetal growth restriction. Ductus venosus seems to be an indirect indicator of intrauterine hypoxia with moderate prognostic value for adverse obstetric outcomes.

Affective Temperament and Glycemic Control - The Psychological Aspect of Obesity and Diabetes Mellitus.

PURPOSE: Affective temperament shows innate predisposition to affective disorders and has been studied in patients with type 2 diabetes mellitus (T2DM) and obesity. Studies describing connections between depressive disorders, obesity and T2DM, show a bidirectional way in which these disorders affect each other. Given that obesity, depression, and T2DM are still growing health problems of our times, the improvement of therapeutic strategies is required. The aim of our study was to evaluate affective temperament in obese individuals with T2DM and pre-diabetes and to investigate the correlations between affective temperaments and glycemic control. MATERIALS AND METHODS: The study enrolled 185 obese individuals (146 females; 39 males) who were diagnosed with pre-diabetes, diabetes or without any carbohydrate disorder. For affective temperament evaluation, Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A) was utilized; for glycemic control, the assessment of hemoglobin A1c (HbA1c) was performed. RESULTS: We did not observe any significant differences of affective temperament between studied groups. In the group of patients with diabetes, depressive, cyclothymic and anxious temperaments positively correlated with HbA1c values indicating worse glycemic control. Inversly, hyperthymic dimension showed negative correlation with HbA1c values. CONCLUSION: Affective temperaments may affect glycemic control in obese individuals with carbohydrate disorders. Individuals with stronger expression of cyclothymic, depressive and anxious temperaments may need more medical aid for better self-management. Hence, TEMPS-A is an easy and useful tool which may significantly improve the compliance in obese patients with carbohydrate disorders.