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  • Original Article

    The use of sulfonylureas by pregnant diabetic women and fetal malformations

    Rev Bras Ginecol Obstet. 1999;21(7):393-397

    Summary

    Original Article

    The use of sulfonylureas by pregnant diabetic women and fetal malformations

    Rev Bras Ginecol Obstet. 1999;21(7):393-397

    DOI 10.1590/S0100-72031999000700005

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    Purpose: to evaluate a possible relationship between fetal malformations (FM) and the use of sulfonylureas (SF) by diabetic pregnant women. Methods: we retrospectively studied 35 type 2 diabetic pregnant women followed at the Pathological Prenatal Care Outpatient Clinic of the University Hospital, Faculty of Medicine of Ribeirão Preto, from 1993 to 1995. Twenty-two of these women had been inadvertently using sulfonylureas during the 1st trimester of gestation (SF group). We determined their prevalence of FM and compared it to that observed for pregnant diabetic women who were only on diet or insulin therapy (group C). We also analyzed other variables such as time of disease, age, metabolic control, and prenatal care. Results: there was no significant difference between groups in terms of age range, duration of diabetes, glycemic control, or early start of prenatal care, with the prevalence of FM being similar for the two groups (8.3% in group C and 13.6% in group SF). The malformations observed in group SF were: renal agenesis, pulmonary hypoplasia and ribbon gonads (patient 1); short limbs and abnormally implanted toes (patient 2); cleft palate, low implanted ears, neck webbing and saddle nose (patient 3), and micrognathia, dysplastic ears, imperforate anus, hypospadia, polydactily, ventricular septal defect and atrial septal defect (patient 4) in group C. Conclusions: these data do not allow us to attribute the malformations detected in group SF to the use of sulfonylureas, although not usually described alterations in diabetic embryopathy occurred in this group.

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  • Original Article

    Ultrasound evaluation of internal genitalia of girls with idiopathic central precocious puberty before and during treatment with GnRH analogs

    Rev Bras Ginecol Obstet. 2006;28(7):410-415

    Summary

    Original Article

    Ultrasound evaluation of internal genitalia of girls with idiopathic central precocious puberty before and during treatment with GnRH analogs

    Rev Bras Ginecol Obstet. 2006;28(7):410-415

    DOI 10.1590/S0100-72032006000700006

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    PURPOSE: to verify, through pelvic ultrasound, the existence of changes in the internal genitalia of girls with central precocious puberty, submitted to treatment with gonadotrophin-releasing hormone (GnRH) analogs. METHODS: pelvic ultrasound was performed in 18 girls with idiopathic central precocious puberty, before and after three months of onset of the treatment with GnRH analogs, to investigate the impact of the therapy on the internal genitalia. Ovarian and uterine volumes, uterine longitudinal length, relation between the longitudinal diameter of the uterine corpus and the uterine cervix, the relation between the anterior-posterior diameter of the uterine corpus and the uterine cervix, and endometrial echogenicity were evaluated. Statistical analysis was performed through Shapiro-Willkis's test, to assess data normality. When normality was present, Student's test t was applied. For data without normality, a non-parametric test (the signal test) was used. RESULTS: after therapy, statistically significant decline of the mean uterine volume (from 5.4 cm³ to 3.0 cm³, p<0.001), of the mean ovarian volume (from 2.2 cm³ to 1.1 cm³, p= 0.004), of the mean uterine longitudinal length (from 4.2cm to 3.4 cm, p=0.001), and of the mean endometrial echogenicity (from 1.8 mm to 0.6 mm, p=0.018) occurred. CONCLUSION: In girls with idiopathic central precocious puberty, pelvic ultrasound is a valid method to assess the efficacy of treatment with GnRH analogs. The main parameters of the therapeutic response were the decrease of uterine and ovarian volume, of uterine longitudinal length, and atrophy or absence of endometrial echogenicity.

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