Pregnancy and delivery in 190 diabetic women are described. Obstetric, medical and neonatal guidelines for treatment are outlined and the following results are reported: 1. The delivery dates suggested by P. White were generally exceeded by 2 weeks. Group A was delivered at term, group B generally in the 38th week, group C between the 37th and 38th week and group D mostly in the 37th week of gestation. 2. Spontaneous delivery was achieved in 60% of the cases; Caesarean section was necessary in 33%, whilst the incidence of vacuum extraction was 5%. 3. The perinatal infant mortality rate in diabetic pregnancy decreased from 22.9% in 1970/71 to 2.7% in 1972/1976. 4. Perinatal mortality was related to the degree of severity of diabetes according to White's classification. 5. The percentage of PBSP cases was lowered from 32% to 24%. Perinatal mortality in the PBSP group decreased from 50% in 1970/71 to 19% in 1972/1976. 6. Hypoglycaemia occurred in 70% of 74 newborn infants submitted to intensive neonatal care. A true glucose value of less than 25 mg% was recorded in 30% of these cases. Hypocalcaemia was present in 16% cases, whilst 62% of the newborn infants suffered from respiratory distress syndrome. Cardiomegaly occurred in 28% of infants. 7. Development and prognosis are judged to be favourable in children of diabetic mothers.

Austria↗

PubMed1977

[Human placental lactogen and chorionic gonadotropin in diabetic pregnancies (author's transl)].

Serial determinations of serum HPL and HCG levels were carried out in 68 diabetic women during the whole course of pregnancy. In diabetic pregnancies of the type B--D according to White's classification, HPL levels were significantly lower than control values from the 10th to the 22nd week. In diabetic pregnancies of the type White A, HPL levels were significantly lower than the normal controls at the 10th and the 38th week, otherwise there was no significant difference between the two groups. A decrease in HPL level occurred in the 37th week in normal pregnancies and in the 34th week in diabetics. Integrated values of HPL over each trimester of pregnancy (which give a measure of the overall hormone production), were all significantly lower in the diabetic pregnancies than in the normal controls. Peak levels of HCG were found from the 8th to 12th week in normal pregnancy; subsequently a continuous fall was observed until the end of pregnancy. HCG levels were significantly higher in diabetic than normal pregnancies following the 30th week and generally rose to the end of pregnancy. The integral HCG values, in diabetics of all White groups, were significantly lower in the first trimester and significantly higher in the third trimester than in the normal controls. There was no difference in integral hormone production between diabetics and controls in the second trimester. A sudden drop in the level of both hormones is a signal of fetal distress.

Chorionic Gonadotropin↗

PubMed1977

The effects of methylphenidate on the handwriting of children with minimal brain dysfunction.

Fifty children with minimal brain dysfunction who had handwriting deficits received methylphenidate or placebo under double-blind conditions. Twenty-six children (52%) showed improvement in hand-writing following treatment with methylphenidate for four weeks. One child receiving placebo had improvement in handwriting, but his handwriting improved further after he was switched to methylphenidate. In general, handwriting tended to deteriorate promptly when drug treatment was discontinued. Thirty-six patients (72%) receiving methylphenidate for four weeks were rated behaviorally improved by teachers; in contrast, seven children (14%) showed behavioral improvement following treatment with placebo. Improvement in attention and behavior, which was ascertained by the use of Conners' Abbreviated Teacher Rating Scale, did not always correspond with improvement in handwriting. Advances in handwriting skills following treatment with methylphenidate may have been directly related to improvement in fine motor coordination. Gains in handwriting were maintained for up to 26 months of follow-up in 21 children who received methylphenidate on a long-term basis.

Attention Deficit Disorder with Hyperactivity↗

PubMed1976