The Relationship between a High Carbohydrate Diet and Oral Glucose Tolerance Test in Pregnancy.

OBJECTIVE: The aim of this study is to examine the impact of carbohydrate ratios in the diet consumed one day prior to the 75-g oral glucose screening test on both the screening test values and the diagnosis of gestational diabetes mellitus in the unselective pregnant population. MATERIAL-METHOD: 83 pregnant women who were under observation in the antenatal clinic of our hospital and underwent glucose tolerance tests were included in the study. The patients were given training by a dietitian to keep nutrition records of the day prior to glucose loading during their previous visits before any glucose loading. A carbohydrate intake of 40-60% was considered as the normal range in terms of the percentage of carbohydrates in the diet. A carbohydrate percentage above 60% was considered to be a high carbohydrate intake. The carbohydrate percentages in their diet over the past 24 hours was compared with the effect on the glucose tolerance test. RESULTS: Out of the 83 pregnant women included in the study, 40 of them had a high carbohydrate diet (HCD) prior to the oral glucose tolerance test (OGTT), and the average carbohydrate percentage of this diet was found to be 62%. The remaining 43 patients had an average carbohydrate percentage of 49% and belonged to the group that had a normal carbohydrate diet (NCD). Out of the 83 pregnant women, 33 of them were at high risk for gestational diabetes mellitus (GDM). In the high-risk patient group, 16 patients had an NCD intake, while 17 patients had a HCD intake. It was determined that a high carbohydrate diet had no significant effect on fasting, first-hour, and second-hour glucose levels, as well as the diagnosis of gestational diabetes mellitus (GDM), in both the unselective population and the high-risk patient population. CONCLUSION: In our study, we concluded that the high carbohydrate ratios in the diets of pregnant women one day prior did not affect the OGTT results or the GDM ratios. This indicates that there is no need for a preparatory diet prior to the OGTT in women with normal dietary habits.

Low Anti-Mullerian Hormone Levels Are Associated with the Severity of Anxiety Experienced by Healthcare Professionals During the COVID-19 Pandemic.

The objective of this study is to investigate a possible correlation between anxiety status and anti-Mullerian hormone (AMH) levels among healthcare professionals who provide medical care directly to COVID-19-positive patients during the recent pandemic. Fifty-two healthcare professionals (nurses, midwives, and residents) who provide medical care directly to COVID-19-positive patients in inpatient clinics or intensive care units were enrolled in this study. Serum AMH levels were analyzed to reflect ovarian reserve. The Beck Anxiety Inventory (BAI) and the State-Trait Anxiety Inventory (STAI-S and STAI-T, respectively) were completed by participants to assess their anxiety status. A linear regression model with participant age as the constant variable was applied to analyze the relationship between inventory scale scores and AMH levels. P-values less than 0.05 were considered statistically significant. The mean AMH value was significantly lower for the participants in the moderate/severe anxiety group compared to the minimal/mild anxiety group (p = 0.007). A linear regression analysis revealed a significant negative correlation between AMH levels and both BAI (B = -0.030, standard error = 0.010, p = 0.004) and STAI-S and STAI-T scores when age was controlled (both p = 0.003). The severity of anxiety experienced during the recent COVID-19 pandemic among healthcare professionals, who provide medical care directly to COVID-19-positive patients, is found to be related to low AMH levels.

The rate of SARS-CoV-2 positivity in asymptomatic pregnant women admitted to hospital for delivery: Experience of a pandemic center in Turkey.

OBJECTIVE: To investigate the rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity in asymptomatic pregnant women admitted to hospital for delivery in a Turkish pandemic center. STUDY DESIGN: This prospective cohort study was conducted in Ankara City Hospital between April, 15, 2020 and June, 5, 2020. A total of 206 asymptomatic pregnant women (103 low-risk pregnant women without any defined risk factor and 103 high-risk pregnant women) were screened for SARS-CoV-2 positivity upon admission to hospital for delivery. Detection of SARS-CoV2 in nasopharyngeal and oropharyngeal samples was performed by Real Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) method targeting RdRp (RNA dependent RNA polymerase) gene. Two groups were compared in terms of demographic features, clinical characteristics and SARS-CoV-2 positivity. RESULTS: Three of the 206 pregnant women participating in the study had positive RT-PCR tests (1.4 %) and all positive cases were in the high-risk pregnancy group. Although, one case in the high-risk pregnancy group had developed symptoms highly suspicious for COVID-19, two repeated RT-PCR tests were negative. SARS-CoV-2 RT-PCR positivity rate was significantly higher in the high-risk pregnancy group (2.9 % vs 0%, p = 0.04). CONCLUSION: Healthcare professionals should be cautious in the labor and delivery of high-risk pregnant women during the pandemic period and universal testing for COVID-19 may be considered in selected populations.

The relationship between first-trimester pregnancy-associated plasma protein-A levels and intrapartum fetal distress development.

OBJECTIVE: To investigate the relationship between the development of intrapartum fetal distress and serum pregnancy-associated plasma protein-A (PAPP-A) levels measured during first-trimester aneuploidy screening tests. MATERIAL AND METHODS: This retrospective study included 283 uncomplicated pregnancies that resulted in full-term live births via spontaneous labor or with the induction by oxytocin. Cases were divided into two groups based on whether their first-trimester PAPP-A multiple of the median (MoM) levels were ≤0.5 (Group 1, n=75) or >0.5 (Group 2, n=208). As primary end points, the rate of cesarean section (C/S), the rate of C/S due to fetal distress, and the umbilical artery blood pH values in cases of C/S for fetal distress were compared between the two groups. Statistical analyses were performed using the Chi-square test and independent samples t-test. P≤0.05 were considered statistically significant. RESULTS: The mean gestational age at birth and the birth weights were significantly lower in Group 1 than in Group 2 (p=0.002 and p=0.007, respectively). Although the rate of C/S was similar between the groups (p=0.823), the rate of C/S due to fetal distress was significantly higher in Group 1 than in Group 2 (68.4% vs. 42%, respectively; p=0.050) and the mean umbilical artery blood pH value for C/S deliveries indicated by fetal distress was lower (p=0.048) in Group 1 than in Group 2. When the mode of delivery was analyzed according to the application of labor induction, both the C/S delivery rates (31.6% in Group 1 and 31.7% in Group 2; p=0.992) and C/S delivery rates due to fetal distress (66.7% in Group 1 and 46.2% in Group 2; p=0.405) were similar in both groups. CONCLUSION: Low PAPP-A levels (≤0.5 MoM) in the first trimester are associated with the risk of intrapartum fetal distress development and the likelihood of C/S for fetal distress. Nonetheless, this risk is not affected by labor induction.

Effects of intravaginally inserted controlled-release dinoprostone and oxytocin for labor induction on umbilical cord blood gas parameters.

OBJECTIVE: To compare the effects of oxytocin and dinoprostone used in labor induction on fetal blood gas parameters. MATERIAL AND METHODS: This prospective randomized trial involved 108 women who completed 37 gestational weeks and who required labor induction prior to normal vaginal birth. Labor was induced in 57 women with an intravenous low dose oxytocin regimen and in 51 with intravaginal dinoprostone (PGE2). Following childbirth, umbilical artery blood gas was analyzed, with pH, pCO2, pO2, HCO3 and base excess (BE) compared in the two groups. RESULTS: Mean age and obstetrical data (gravidity, parity, gestational weeks and birthweight) were similar in the two groups (p>0.05). All infants had 1 and 5 minute APGAR scores ≥7. Umbilical artery blood pH was similar in the oxytocin and dinoprostone groups (7.31±0.07 vs. 7.31±0.05, p=0.780), as were the other blood gas parameters (pCO2, pO2, base excess and HCO3; p>0.05 each). CONCLUSION: Induction of labor with either oxytocin or dinoprostone in women with uncomplicated term pregnancies had no adverse effects on umbilical artery blood gas parameters.