II.

Interpregnancy metabolic syndrome predisposes to recurrent pre-eclampsia.

PIH and preeclampsia are associated with minor alterations in antioxidant levels without signs of oxidative stress. Detection of ethene in exhaled air seems a promising noninvasive method to study lipid peroxidation but further research in more severe preeclampsia is needed.

Aim: To compare the effect of suprapubic and transurethral catheterization on postvoid residual volumes (PRVs) after cystocele repair. Methods: 126 women who underwent pelvic organ prolapse surgery including cystocele repair were randomized to suprapubic or transurethral catheterization. At the third postoperative day, PRVs were measured. The number of women with PRV >150 ml, need for prolonged catheterization, recatheterization, length of hospital stay, frequency of urinary tract infections and complications were determined. Results: PRVs exceeded 150 ml in 13 out of 64 (20%) and 14 out of 62 (23%) women in the suprapubic and transurethral group, respectively (p = 0.76). In the suprapubic group a higher rate of urine leakage was noted (27 vs. 7%, p = 0.003). 10 women (16%) allocated to the suprapubic group switched to transurethral catheterization, because of problems with the suprapubic catheter. No protocol deviations were reported in the transurethral group. Of the women in both groups, 9% developed urinary tract infections (p = 0.93). Conclusions: Suprapubic catheterization was comparable to transurethral catheterization in the prevention of postoperative voiding dysfunction after vaginal prolapse surgery, but it was associated with a higher rate of complications.

BackgroundThe World Health Organization (WHO) adopted more stringent diagnostic criteria for GDM in 2013, to improve pregnancy outcomes. However, there is no global consensus on these new diagnostic criteria, because of limited evidence. The objective of the study was to evaluate maternal characteristics and pregnancy outcomes in two cohorts in the Netherlands applying different diagnostic criteria for GDM i.e. WHO-2013 and WHO-1999.MethodsA multicenter retrospective study involving singleton GDM pregnancies in two regions, between 2011 and 2016. Women were diagnosed according to the WHO-2013 criteria in the Deventer region (WHO-2013-cohort) and according to the WHO-1999 criteria in the Groningen region (WHO-1999-cohort). After GDM diagnosis, all women were treated equally based on the national guideline. Maternal characteristics and pregnancy outcomes were compared between the two groups.ResultsIn total 1386 women with GDM were included in the study. Women in the WHO-2013-cohort were older and had a higher pre-gestational body mass index. They were diagnosed earlier (24.9 [IQR 23.3–29.0] versus 27.7 [IQR 25.9–30.7] weeks, p = < 0.001) and less women were treated with additional insulin therapy (15.6% versus 43.4%, p = < 0.001). Rate of spontaneous delivery was higher in the WHO-2013-cohort (73.1% versus 67.4%, p = 0.032). The percentage large-for-gestational-age (LGA) neonates (birth weight > 90th percentile, corrected for sex, ethnicity, parity, and gestational age) was lower in the WHO-2013- cohort, but not statistical significant (16.5% versus 18.5%, p = 0.379). There were no differences between the cohorts regarding stillbirth, birth trauma, low Apgar score, and preeclampsia.ConclusionsUsing the new WHO-2013 criteria resulted in an earlier GDM diagnosis, less women needed insulin treatment and more spontaneous deliveries occurred when compared to the cohort diagnosed with WHO-1999 criteria. No differences were found in adverse pregnancy outcomes.