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PubMed2002

Management of missed abortion: comparison of medical treatment with either mifepristone + misoprostol or misoprostol alone with surgical evacuation. A multi-center trial in Copenhagen county, Denmark.

OBJECTIVE: To compare the efficacy of two different medical treatment regimens: mifepristone 600 mg orally + misoprostol 0.4 mg vaginally (Mf + Ms) or misoprostol 0.4 mg vaginally (Ms) with conventional surgical evacuation (SE) in women with missed abortion. MATERIALS AND METHODS: Prospective crossover study with alternating regimens every 4 months. The three university clinics of Obstetrics and Gynecology in Gentofte, Herlev and Glostrup of Copenhagen County. During the period October 1999 to October 2000, 176 women with missed abortion accepted to participate in the study. RESULTS: The proportion of women who needed surgical evacuation after medical treatment, number of women who needed re-evacuation after primary surgical evacuation, duration of vaginal bleeding, treated infections, need of analgesics, and the subjective experiences from the participating women. Fifty-four, 73 and 49 patients were randomized to Mf + Ms, Ms and SE, respectively. Within 1 week, complete expulsion occurred in 40 (74%), 52 (71%), 47 (96%) of the three arms, respectively. Duration of bleeding was 6.9, 7.1 and 2.5 days in the three arms, respectively (p < 0.01). Women with an initial plasma chorionic gonadotrophine (p-hCG) between 2000 and 20 000 IU/l and a gestational age less than 75 days had a significantly better response to the medical treatment than those not fulfilling these two criteria. Initial p-progesterone did not correlate with success of medical treatment. MAIN OUTCOME MEASURES: Proportion of women who needed surgical evacuation after medical treatment, and the number of women who needed re-evacuation after primary surgical evacuation, duration of vaginal bleeding, treated infections, the need of analgesics, and subjective experiences from participating women. CONCLUSION: Vaginal misoprostol 0.4-0.6 mg is effective in most patients with missed abortion. Pre-treatment with the antiprogesterone mifepristone does not increase the success rate. The selection of women with missed abortion for medical treatment based on gestational age and initial p-hCG level may increase the success of medical treatment significantly.

Abortifacient Agents↗

PubMed1977

Spontaneous abortion in perspective. A 7-year study.

Ten per cent of all pregnancies end in spontaneous abortion. Only by thorough history taking, physical examination and selected biochemical and biological investigations can potential causes of abortion be recognized and treated. The lesser known factors concerned with abortion are emphasized, and the role played by human chorionic gonadotrophin therapy in selected cases is considered.

Abortion, Spontaneous↗

PubMed2004

Ectopic pregnancy and medical abortion.

OBJECTIVE: Medical abortion regimens have become more widely used to terminate early pregnancies. Medical abortion providers are concerned to diagnose and exclude women with ectopic pregnancy before initiating treatment, as with any early pregnancy termination. Yet, there is little information about whether the various pretreatment screening methods used are adequate. We reviewed published literature to determine the overall success of screening for ectopic pregnancy before medical abortion treatment. DATA SOURCES: We searched MEDLINE for articles on medical abortion regimens published before July 2003. METHODS OF STUDY SELECTION: We selected English language articles of studies of medical abortion with sample sizes greater than 100, which reported on ectopic pregnancy diagnosed after medical abortion treatment. Fifty-seven of 85 prospective studies and randomized trials (69%) met these inclusion criteria. We also included data from 2 unpublished studies because they were large and well-controlled and because they included serious adverse events known to us, which we did not deem fair to exclude from our analysis. TABULATION, INTEGRATION, AND RESULTS: Each article was reviewed by one author. Data from selected studies were compiled, and the frequency of ectopic pregnancy diagnosed after medical abortion treatment was calculated. Ectopic pregnancy was diagnosed very infrequently following medical abortion procedures, occurring in only 10 of 44,789 (0.02%) women. CONCLUSION: The very low frequency of ectopic pregnancies diagnosed after medical abortion treatment demonstrates that the various pretreatment screening methods that providers use to exclude patients with ectopic pregnancies are successful. Further, there is no evidence to suggest that medical abortion treatment leads to unusual complications for women with ectopic pregnancies.

Abortion, Induced↗

PubMed1977

The effect of oxytocin on hypertonic saline abortion.

Oxytocin was infused in 22 randomly selected pregnant women after extraamniotic hypertonic saline instillation. In another 24 pregnant women no oxytocin was infused at midtrimester abortion. There was no difference between the two groups in mean time from saline injection to expulsion of the fetus.

Abortion, Induced↗

PubMed2001

Spontaneous abortions with increased CD5 positive cells in the placental tissue during the first trimester of gestation.

Most spontaneous abortions occur before 12 weeks' gestation, and most are due to chromosomal errors in the conceptus. Relatively few truly spontaneous abortions take place between 12 and 20 weeks' gestation. Thereafter, between 20 and 30 weeks another type of premature spontaneous termination due to ascending infection becomes prevalent. The number of cells expressing the various lymphocytic markers changes throughout pregnancy. In the present study, we investigated the immunohistochemical expression of mononuclear infiltrations in paraffin-embedded placentas, from fetuses after spontaneous abortion (8th, 10th, and 12th week of gestational age), and those after therapeutic abortion at the same time, using a panel of monoclonal antibodies for the identification of leukocytes (CD45/LCA), B-lymphocytes (CD20/L-26), T-lymphocytes (CD45RO/UCHL1) and CD5 cells. Immunologic factors in human reproductive failure are plausible mechanisms of infertility and spontaneous abortion. Approximately 25% of cases of premature ovarian failure appear to result from an autoimmune etiology. Unfortunately, current therapeutic options for these women are limited to exogenous hormone or gamete substitution. Local inflammation at the sites of endometriosis implants are postulated to mediate the pain and reduce fecundability associated with this clinical syndrome. The recruitment of immune cells, particularly monocytes and T cells, neovascularization around foci of invading peritoneal lesions, and the possible development of antiendometrial autoantibodies support an immunologic basis of this disorder. To date, treatment of pain and infertility associated with endometriosis is primarily surgical, although immune-based adjuvants are theoretical possibilities for the future. Finally, although hypotheses supporting immunologic mechanisms of recurrent pregnancy loss have been popular over the past decade, most clinical investigations in this area do not provide compelling evidence for this position. Reputable specialists in reproductive medicine use experimental immunotherapies judiciously in selected cases of repetitive abortion. For example, the use of anticoagulation therapy can be beneficial in cases with documented antiphospholipid antibodies. At present, however, efficacious immunotherapy protocols for general application have not been established. Despite these caveats, continued strides in our understanding of human reproductive immunology, should yield considerable future progress in this field. We conclude that, 1) maternal cells, probably CD45RO/UCHL1 positive cells, cross the maternofetal barrier and participate in spontaneous (involuntary) abortions, 2) a small proportion of maternal cells (approximately 30%), probably CD5 positive cells, also cross the maternal fetal barrier and cause growth delay and recurrent reproductive failure. The results were statistically significant (p < 0.0001, Student's t-test).

Abortion, Spontaneous↗

PubMed2006

Imbalance of mononuclear cell infiltrates in the placental tissue from foetuses after spontaneous abortion versus therapeutic termination from 8th to 12th weeks of gestational age.

Placental macrophages (Hofbauer cells) are located close to trophoblastic cells and foetal capillaries, which make them perfect candidates for involvement in regulatory processes within the villous core. Their capacity of producing several cytokines and prostaglandin-synthesising enzymes, and expressing vascular endothelial growth factor, indicate a possible role in placental development and angiogenesis in order to support pregnancy. Common cells to Hofbauer macrophages sharing similar cell surface markers (HLA-A, -B, -C and leukocyte common antigen) have been reported in the stroma, decidua and amnion, indicating additional foetal protection. Yet this is not always the case. Most spontaneous abortions occur before 12 weeks' gestation, and most are due to chromosomal errors in the conceptus. Relatively few truly spontaneous abortions take place between 12 and 20 weeks' gestation. Thereafter, between 20 and 30 weeks, another type of premature spontaneous termination becomes prevalent, which is due to ascending infection. The numbers of cells expressing the various markers of the monocytemacrophage lineage change throughout pregnancy. In the present study, we investigated the immunohistochemical expression of mononuclear infiltrations in paraffin-embedded placentas, from foetuses after spontaneous abortion (8th, 10th and 12th weeks of gestational age), and those after therapeutic abortion at the same time, using a panel of monoclonal antibodies for the identification of leukocytes (CD45/LCA), B-lymphocytes (CD20/L-26), T lymphocytes (CD45RO/UCHL1), CD68 and CD14 cells. Immunologic factors in human reproductive failure are plausible mechanisms of infertility and spontaneous abortion. Approximately 25% of cases of premature ovarian failure appear to result from an autoimmune aetiology. Unfortunately, current therapeutic options for these women are limited to exogenous hormone or gamete substitution. Local inflammations at the sites of endometriosis implants are postulated to mediate the pain and reduced fecundability associated with this clinical syndrome. The recruitment of immune cells, particularly monocytes and T-cells, neovascularisation around foci of invading peritoneal lesions, and the possible development of antiendometrial autoantibodies support an immunologic basis of this disorder. To date, treatment of pain and infertility associated with endometriosis is primarily surgical, although immune-based adjuvants are theoretical possibilities for the future. Finally, although hypotheses supporting immunologic mechanisms of recurrent pregnancy loss have been popular over the past decade, most clinical investigations in this area do not provide compelling evidence for this position. Reputable specialists in reproductive medicine use experimental immunotherapies judiciously in selected cases of repetitive abortion. For example, the use of anticoagulation therapy can be beneficial in cases with documented antiphospholipid antibodies. At present, however, efficacious immunotherapy protocols for general application have not been established. Despite these caveats, continued strides in our understanding of human reproductive immunology should yield considerable future progress in this field. During the physiological changes that occur in the first and in the beginning of the second trimester of pregnancy, spiral arteries of the placental bed are converted into the uteroplacental arteries. The essence of this conversion consists of losing the muscular elements in the vessel walls, making them unable to respond to vasomotor influences. Cells that infiltrate the walls of spiral arteries and replace their normal elements are called migratory, non-villous or intermediate trophoblastic cells. Besides infiltrating and replacing the anatomic structures of spiral arteries, intermediate trophoblastic cells also penetrate into the lumina of these vessels forming endovascular plugs. These plugs are one of the reasons why early uteroplacental blood flow cannot be visualised, even with transvaginal ultrasound, during the first 12 weeks of gestation. In uncomplicated pregnancies, the endovascular trophoblast is bound to disappear by the end of the second trimester of pregnancy, but the literature on this topic is scarce. Here we describe the detection, isolation and characterisation of CD45RO-, L26- and CD68/CD14-positive cells from human early pregnancy deciduas. These cells were found in close vicinity to endometrial glands, with preference to the basal layer of the decidua. We conclude that (1) maternal cells, apparently CD45RO/UCHL1-positive cells, cross the maternofoetal barrier and participate in spontaneous (involuntary) abortions, and (2) a small proportion of maternal cells (approximately 30%), apparently CD68/CD14-positive cells, also cross the maternal-foetal barrier and cause growth delay and recurrent reproductive failure. Further investigation of involvement of the intercellular adhesion molecules 1 and 2, platelet endothelial cell adhesion molecule, vascular cell adhesion molecule and E-selectin in leukocyte accumulation will be needed to support the passage of maternal cells to the foetus. The results were statistically significant (P<0.0001, Student's t-test).

Abortion, Induced↗

PubMed1995

Expectant management of first-trimester spontaneous abortion.

Approximately 15% of registered pregnancies end in spontaneous abortion, and for 50 years or so dilatation and curettage (D&C) has been the usual management. In a prospective randomised trial we compared the clinical results after either expectant management or D&C, for miscarriages of less than 13 weeks' gestation in which transvaginal ultrasound examination showed intrauterine tissue and/or blood clots with a diameter 15-50 mm. 103 patients were randomised to expectant management and spontaneous resolution of pregnancy occurred within 3 days in 81 cases (79%). 52 patients were randomised to D&C. 3 infections were diagnosed among patients who underwent expectant management (3%); 5 infections and 1 case of postoperative anaemia were observed among patients randomised to D&C (11%). The duration of vaginal bleeding was a mean of 1.3 days longer in the expectant management group (p < 0.02). Convalescence time, time during which patients experienced pain, and packed-cell volume 3 and 14 days after inclusion did not differ significantly between the groups. This study shows that expectant management of selected cases of spontaneous abortion has a similar outcome to D&C.

Abortion, Spontaneous↗

PubMed2004

Acceptance rate of HIV testing among women seeking induced abortion in Benin City, Nigeria.

Although the campaign against HIV has been intensive, it has been focused mainly on the public health implications. Little or no attention is specifically directed at encouraging the public to know their HIV serostatus. The actual public health burden due to this infection is therefore not known. Accurate data on the health burden is critical for national planning on preventive and other interventional measures. Using a semi-structured self-administered questionnaire, we interviewed 1051 women seeking induced abortion in four randomly selected private clinics in Benin City between January and September 2002. The blood samples of those who accepted HIV testing were collected and screened at the University of Benin Teaching Hospital. The women were aged between 16 and 46 years (mean 31.1+/-6.7 years). One hundred and thirty seven women (13%) accepted HIV testing. Of the 1051 women, 1001 (95.2%) had multiple sexual partners and 722 (68.8%) regularly practiced unprotected sex. All were aware of HIV/AIDS. The older women were more likely to accept voluntary HIV testing than the younger ones. Acceptance rate for voluntary HIV testing was low in both the employed and unemployed and much lower among full time housewives (p = 0.01). We therefore recommend that HIV campaign programmes should include strategies aimed at arousing public interest in voluntary HIV testing.

AIDS Serodiagnosis↗

PubMed2004

Efficacy of live Chlamydophila abortus vaccine 1B in protecting mice placentas and foetuses against strains of Chlamydophila pecorum isolated from cases of abortion.

The efficacy of Chlamydophila abortus vaccine strain 1B in protecting against two selected Chlamydophila pecorum strains, isolated from an aborted goat (M14) in Morocco and a ewe (AB10) in France, was investigated in a mouse model, by comparing the reduction in number of bacteria in the placentas of vaccinated mice challenged intraperitoneally at 11 days of pregnancy with the reference C. abortus (AB7) and C. pecorum (M14, or AB10) strains, to those of unvaccinated mice. Vaccine 1B was shown to provide effective protection against the field strains of C. pecorum, since it significantly reduced the placental Chlamydophila colonisation. The two C. pecorum strains were not sufficiently abortifacient in mice to use reduction in abortion as a criterion of protection.

Abortion, Veterinary↗

PubMed1988

Transabdominal chorionic villus sampling: analysis of 350 consecutive cases.

We report a series of 350 patients submitted to transabdominal chorionic villus sampling (CVS). A technique using two ultrasound-guided needles and a suction pump was used. In most cases, the procedure was performed between 9 and 13 weeks. Twenty-one pregnancies were selectively terminated; nine spontaneous abortions followed the procedure and one fetal loss after 28 weeks was recorded; 153 pregnancies are in progress and 169 delivered fetuses are alive and well. Transabdominal biopsy is a feasible and effective technique for CVS.

Abdominal Muscles↗

PubMedDate not supplied

Selective blockage of the sensory terminal activites by micro-application of tetrodotoxin in the frog muscle spindle.

Micro-application of tetrodotoxin to the sensory nerve terminal of the frog muscle spindle made a semi-blocked condition, in which propagated spikes were blocked selectively but reversibly, while abortive spikes survived. In the semi-blocked condition an antidromic spike was often followed by an abortive spike without a significant pause, in contrast with the normal condition in which the antidromic spike was always followed by an abortive spike or a propagated spike with a pause more than 50-100 msec. An analysis of the spike train as a stochastic point process suggests that the abortive spikes originate at the places which the antidromic spike can scarcely invade in the semi-blocked condition.

Animals↗

PubMed2002

Induced abortions among adolescent women in rural Maharashtra, India.

In a study in rural Maharashtra, India, adolescents constituted 13.1% of the 1717 married women who had an induced abortion during an 18-month period in 1996-1998. The 197 adolescents who were subsequently interviewed had a lesser role in the decision-making process on abortion than women older than them. Most abortions were obtained in the private sector. Though spacing was the main reason for adolescents seeking abortion, prior contraceptive use among them was low. Additionally, they were less likely to receive post-abortion contraceptive counselling or to adopt contraception. Sex selection accounted for more than a fifth of abortions among adolescents. Additional qualitative data from 43 never-married and separated adolescents seeking abortion showed that non-consensual sex made many pregnancies unwanted, and cost, limited mobility, lack of family and partner support and the need for privacy to prevent stigma led many to go to traditional providers, even though safer options existed. Family planning programmes need to address the contraceptive needs of newly married adolescent women as well as unmarried adolescents. Informing adolescents of their legal rights, sensitising providers to adopt an empathetic attitude, and exploring innovative ways of increasing access to safe services for unmarried adolescents are all recommended.

Abortion, Induced↗

PubMed2000

Poxvirus as a vector to transduce human dendritic cells for immunotherapy: abortive infection but reduced APC function.

Dendritic cells (DC) are potent antigen-presenting cells (APC). Ongoing preclinical and clinical studies exploit this capacity for the immunotherapy of tumors. We tested vaccinia virus (VV) as a vector to transduce human DC. Immature and mature DC were prepared from blood monocytes and infected with (1) recombinant VV expressing GFP to analyze infection rates, virus replication in DC and the effect of infection on DC phenotype and (2) recombinant VV expressing beta-galactosidase (betaGAL) under the control of viral early, intermediate and late promoters to analyze the poxvirusdriven gene expression. While the infection rate in DC was comparable to a permissive fibroblast cell line, viral betaGAL gene expression was limited to early promoters. Genes under the control of virus late promoters were not expressed by VV in DC, indicating an abortive infection. VV infection selectively reduced the surface expression of the costimulatory molecule CD80 and the DC maturation marker CD83 on mature DC while other surface molecules including CD86 and MHC remained unchanged. In line with this finding, there was a pronounced reduction in the capacity of VV-infected DC to stimulate allogeneic or autologous T cells in mixed lymphocyte reactions. Furthermore, VV infection inhibited the maturation of immature DC after exposure to proinflammatory cytokines. These results indicate that VV-derived vectors may have complex effects on their target cells. In the case of DC used for immunotherapy, this may be detrimental to their function as potent APC and particularly their capacity to activate T helper cells.

Antigen Presentation↗

PubMed1992

From serotonin receptor classification to the antimigraine drug sumatriptan.

After the synthetic serotonin 5-hydroxytryptamine (5-HT) became available in the early 1950s, attempts were soon under way to study the nature of 5-HT receptors. Using the guinea-pig isolated ileum, Gaddum and Picarelli (1957) suggested that 5-HT-induced contractions were mediated by a morphine-sensitive "M" receptor located on the parasympathetic ganglion and a dibenzyline-sensitive "D" receptor located on the smooth muscle. Though this classification ws used during the next three decades, it was realized that some effects of serotonin, for example vasoconstriction within the carotid vascular bed, were not mediated by either "M" or "D" receptors. When radioligand binding studies led to the identification of 5-HT1 and 5-HT2 "receptors" in the rat brain membranes, it became increasingly apparent that the two receptor classifications were not identical. Thus, a new framework for serotonin receptor nomenclature and classification was proposed: 5-HT1-like (5-HT1), 5-HT2 (formerly "D") and 5-HT3 (formerly "M") receptors. At the present time, several subtypes of 5-HT1 receptors as well as a 5-HT4 receptor are also recognized. As the serotonin receptor classification was emerging to indicate that carotid vasoconstriction by serotonin is mediated by a subtype of 5-HT1 receptors, on the migraine front it was being suggested that the disease is associated with vasodilation within the cranial extracerebral circulation and deranged serotonin metabolism and that certain antimigraine drugs caused a selective carotid vasoconstriction, probably via serotonin receptors. Therefore, Humphrey and colleagues conceived that synthesis of serotonin derivatives may lead to a compound that would elicit highly selective carotid vasoconstriction and abort migraine attacks. Indeed, via the synthesis of 5-carboxamidotryptamine and AH25086, sumatriptan was designed. The drug acts as an agonist at the vasoconstrictor 5-HT1 receptor subtype and has proved highly effective in the therapy of migraine attacks.

Animals↗

PubMed1996

The shaping of the brain-specific T lymphocyte repertoire in the thymus.

We have shown in several distinct experimental systems that the immune system of intact Lewis rats contains T cells which, upon activation, are able to mediate autoimmune brain inflammation. These T cells seem to differentiate within the thymus although the autoantigens are produced (and presumably expressed in a recognizable fashion) within the thymic medulla. Furthermore, an intact fully MHC compatible thymic microenvironment seems to be required for the development of all features of the autoimmune TCR repertoire. Biased utilization of V beta 8.2 gene for the TCR, a hallmark of the Lewis rat T cell response to MBP, is only seen in T cells having matured in thymuses entirely composed of stroma elements of rat origin. It seems that the thymus contains a large spectrum of protein structures, which hitherto had been considered autoantigens specific for "peripheral" tissues, and, most surprisingly, components of the CNS, the classical "sequestered" organ. Deletion of autoreactive T cell clones by many local intrathymic autoantigens is leaky, at best. The reduced expression of CD4 on thymus-derived autoreactive T cells may be construed to reflect abortive efforts of negative selection. Alternatively, however, it may be worthwhile to consider a positive role for intrathymic autoantigens and their complementary T cells clones. It is possible that the requirement of an intact thymus milieu for the typical, V beta 8.2 dominated MBP specific T cell repertoire in the Lewis rat could reflect self peptide presentation by thymus epithelium cells in positive selection stages. In that case, the unusual diversity of thymic autoantigens could indeed have a role in shaping the immune system's TCR diversity, possible in the sense of an "immunological homunculus" as postulated by Cohen (Cohen 1992). Finally, there is a need to explain the mechanisms that in the healthy organism prevent the numerous, potentially autoaggressive T cell clones from attacking the body's own tissues. This is especially important, as T cells reactive against potentially pathogenic autoantigens, e.g. MBP (Ota et al. 1990, Pette et al. 1990b) and acetylcholine receptor (Salvetti et al. 1991, Sommer et al. 1991), are seen at especially high frequency in the human immune repertoire. Clearly, in all experimental paradigms investigated, activation of self-reactive T cells was the critical prerequisite for induction of autoimmune disease. Thus, in principle, prevention of such activation would be one way to maintain self tolerance. The mechanisms that achieve this goal in most individuals remain to be elucidated.

Animals↗

PubMed1989

Effects of social stress during early pregnancy on litter size and sex ratio in the golden hamster (Mesocricetus auratus).

Primiparous female hamsters were mated to proven breeders and stressed during early pregnancy. Females were housed singly throughout gestation except for Days 4, 5 and 6 when they were paired for 10-min intervals 3 times each day with another female matched for age, weight and day of pregnancy. Within each of the pairs, one female was consistently dominant to the other. Controls were exposed to a novel area instead of a conspecific. At parturition, all pups were counted, sexed and weighed. There were no significant differences between litter sizes or sex ratios (defined as % male) of control and dominant females. Litter sizes produced by control or dominant dams were significantly larger than those of subordinate dams, and litter sex ratios of dominants were significantly higher than those of subordinates. Subordinate dams produced fewer males than did dominant dams, but there was no difference in the number of females produced. Also, subordinate dams produced smaller pups than control dams. Examination of uterine implantation sites and fetal resorptions indicated that fetal loss occurred between Days 5 and 10 of pregnancy. These results suggest that subordinate dams produce smaller litters via selective resorption or spontaneous abortion of males in utero and that those males they do produce are smaller than those produced by dominant or control dams. We suggest that males are more susceptible in utero to effects of maternal stress in this species, and may require more maternal investment to survive to term.

Animals↗

PubMed2003

Ethics of research and the pregnant patient.

In this chapter, we address ethical issues in research involving fetuses and pregnant women, with particular attention to the emerging issue of gene-transfer research. Ethical analyses and arguments are based on the concept of the fetus as a patient. The implications of this concept for the ethics of fetal research are identified. The discussion of gene-transfer research extends those implications to address issues concerning informed consent, assessment of potential fetal and neonatal morbidity in study design, prenatal diagnosis after gene transfer, selection criteria based on abortion preference, science by press conference, germline risks, and public oversight.

Aborted Fetus↗

PubMed2003

[Complications in women with pre-gestational diabetes and glycemic control estimated by general glycemic control index (GCI)].

UNLABELLED: Pre-gestational diabetes is a serious risk factor in pregnancy and delivery. Complications during pregnancy in this group of women depend on the glycemic control and on the clinical course of diabetes. MATERIAL AND METHOD: On the period of 1991-2001, 186 pregnant women with diabetes diagnosed before pregnancy were hospitalized in Ob/Gyn Department, Medical University of Bydgoszcz. In this study, 178 deliveries and 8 abortions were analyzed. The selected glycemic control indices-GCI (General Control Index) were analyzed in diabetic women with non-complicated pregnancies and in women with complications during pregnancy. RESULTS: The most frequent complications during pregnancy were premature delivery (32%) and hypertension (13%). Deliveries before the end of 37 week of pregnancy were more frequent in women with more complicated diabetes. Glycemic control in diabetic mothers who delivered prematurely was worse then in women with normal outcome. An increased rate of congenital malformations (6.7%) in the newborns were noted in women with very poor glycemic control in the first months of pregnancy. Perinatal mortality was higher than that of the non-diabetic population, and was at the level of 3.4%. CONCLUSIONS: 1. Glycemic control in women with diabetes diagnosed before pregnancy who delivered prematurely, was worse then in women who delivered at the term. 2. High rate of the congenital malformations (6.7%) in the newborns was observed in patients with very poor glycemic control in the first months of pregnancy.

Blood Glucose↗