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Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(11):691-697
DOI 10.1590/S0100-72032005001100010
This is both a synthesis and a review of the major research findings, with the aim of validating Rudge's group IB. In this group of pregnants, screening for gestational diabetes was positive while the diagnosis was negative (normal 100 g-oral glucose tolerance test 100 g-OGTT). Nonetheless, the variations in glucose levels observed throughout the day, and confirmed by the glycemic profile (GP), characterized diurnal hyperglycemia, which accounts for maternal risk and adverse perinatal outcome. The description of this group is unique for both the establishment of the diagnosis during gestation and the follow-up of both the mother and the infant. These pregnancies have been erroneously classified as "low risk" and have not been diagnosed or treated. The IB group corresponds to 13.8% of the pregnant women screened in our service. This rate, added to the 7% of pregnancies complicated by diabetes, increase the occurrence of hyperglycemic disorders during gestation to up to 20.0%. In Rudge's group IB: a) perinatal mortality rate is 41‰, which is similar to that observed among diabetic pregnant women and 10 times higher than that found among non-diabetics; b) the observed placental abnormalities (both morphological and functional) differed from those seen in non-diabetic and diabetic pregnant women, indicating an adjustment to maintain functional activities that facilitated the passage of glucose to the fetus and explained fetal macrosomia (53.8% in non-treated pregnancies); c) maternal risk for hypertension, obesity and hyperglycemia was high and seemed to reproduce a model of metabolic syndrome, favoring the potential risk for future diabetes; d) 10 years after the index-pregnancy, type 2 diabetes was confirmed in 16.7% of the women in group IB. The authors suggest the development of multicentric studies in order to identify biomarkers specific for Rudge's group IB and establish protocols for the diagnosis of gestational hyperglycemic disorders using the combination GP + 100g-GTT as a standard. This procedure may cause an impact on the morbidity/mortality rate among pregnancies complicated by diurnal hyperglycemia.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(11):691-697
DOI 10.1590/S0100-72032005001100010
This is both a synthesis and a review of the major research findings, with the aim of validating Rudge's group IB. In this group of pregnants, screening for gestational diabetes was positive while the diagnosis was negative (normal 100 g-oral glucose tolerance test 100 g-OGTT). Nonetheless, the variations in glucose levels observed throughout the day, and confirmed by the glycemic profile (GP), characterized diurnal hyperglycemia, which accounts for maternal risk and adverse perinatal outcome. The description of this group is unique for both the establishment of the diagnosis during gestation and the follow-up of both the mother and the infant. These pregnancies have been erroneously classified as "low risk" and have not been diagnosed or treated. The IB group corresponds to 13.8% of the pregnant women screened in our service. This rate, added to the 7% of pregnancies complicated by diabetes, increase the occurrence of hyperglycemic disorders during gestation to up to 20.0%. In Rudge's group IB: a) perinatal mortality rate is 41‰, which is similar to that observed among diabetic pregnant women and 10 times higher than that found among non-diabetics; b) the observed placental abnormalities (both morphological and functional) differed from those seen in non-diabetic and diabetic pregnant women, indicating an adjustment to maintain functional activities that facilitated the passage of glucose to the fetus and explained fetal macrosomia (53.8% in non-treated pregnancies); c) maternal risk for hypertension, obesity and hyperglycemia was high and seemed to reproduce a model of metabolic syndrome, favoring the potential risk for future diabetes; d) 10 years after the index-pregnancy, type 2 diabetes was confirmed in 16.7% of the women in group IB. The authors suggest the development of multicentric studies in order to identify biomarkers specific for Rudge's group IB and establish protocols for the diagnosis of gestational hyperglycemic disorders using the combination GP + 100g-GTT as a standard. This procedure may cause an impact on the morbidity/mortality rate among pregnancies complicated by diurnal hyperglycemia.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(10):212-216
DOI 10.1590/S0100-72032002001000006
PURPOSE: to compare two methodologies for the calculation of placental volume in normal term pregnancies: one according to the Archimedes principle and the other to the cylinder volume, to estimate the absolute placental densities. Also, to define the methodology which relates to the weight and to the newborn classification. METHOD: fifty placentas from normal term pregnancies were tested by the two methodologies to estimate the placental volume and absolute density: a) Archimedes principle, and b) the cylinder volume with two possible different heights. The absolute placental densities were calculated, respectively, by the quotient between the placenta weight, properly standardized, and the different estimated volumes. RESULTS: most of the pregnant women had more than one gestation, average age of 25.4 years, mean placental volume between 547.8 and 610 cm³ and mean density between 0.94 and 1.14 g/cm³, depending on the used methodology. CONCLUSIONS: the Archimedes principle was the most appropriate methodology to estimate the term placental volume, best correlating with the newborn weight, the placental index and the classification of newborn weight in relation to gestational age.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(10):212-216
DOI 10.1590/S0100-72032002001000006
PURPOSE: to compare two methodologies for the calculation of placental volume in normal term pregnancies: one according to the Archimedes principle and the other to the cylinder volume, to estimate the absolute placental densities. Also, to define the methodology which relates to the weight and to the newborn classification. METHOD: fifty placentas from normal term pregnancies were tested by the two methodologies to estimate the placental volume and absolute density: a) Archimedes principle, and b) the cylinder volume with two possible different heights. The absolute placental densities were calculated, respectively, by the quotient between the placenta weight, properly standardized, and the different estimated volumes. RESULTS: most of the pregnant women had more than one gestation, average age of 25.4 years, mean placental volume between 547.8 and 610 cm³ and mean density between 0.94 and 1.14 g/cm³, depending on the used methodology. CONCLUSIONS: the Archimedes principle was the most appropriate methodology to estimate the term placental volume, best correlating with the newborn weight, the placental index and the classification of newborn weight in relation to gestational age.
