Gestational diabetes mellitus is a common medical disorder of pregnancy. Diabetic ketoacidosis is a complication that may affect both maternal and perinatal wellbeing adversely. It is rare, most often involving women with type 1 or type 2 diabetes, but occasionally can be seen in gestational diabetes mellitus. Here are two cases of ketoacidosis seemingly triggered by glucose ingestion for the oral glucose tolerance test in previously normoglycemic women, posing a diagnostic and therapeutic challenge. Prevention of such complications must be considered when treating high-risk pregnant women> 40 years of age, pregnant as a result of assisted reproductive techniques. Fasting blood glucose checked before ingestion of the glucose in a selected group of women may be one way of avoiding this complication. This suggestion may put women at risk of prolonged fasting and stretching services. Glucose tolerance test is a diagnostic test, and these cases demonstrate a rare complication.
Background:
Background: Ultrasound has become an invaluable tool in our daily practice. Its role in screening for adhesions has been tested since the 1990s.
Objective:
This study aims to determine the role of the visceral slide test as a screening method to predict abdominal wall adhesions in women undergoing gynecological surgery.
Methods:
We conducted a prospective observational cohort study from August 2017 to July 2019 in women undergoing elective abdominopelvic surgery for a gynecological indication. Preoperatively, a visceral slide test was performed in 5 specified zones on the abdomen and the test results were clinically correlated with the presence, severity, and extent of adhesions intra-operatively.
Results:
Results were reported as mean, standard deviation, range of values or number and percentage. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy (including 95% confidence interval for all) of visceral slide test were calculated to determine intra-abdominal adhesions . We also found a correlation between the number of negative slide tests and PAI scores using Spearman’s correlation test. Of the 339 women who completed the study, 41.2% had a previous history of abdominopelvic surgery. In this study, the visceral slide test was found to have a sensitivity of 70.87% ( 95%CI 62.15-78.59), specificity of 86.32% (95% CI 80.95-90.64), positive predictive value (PPV) of 75.63% ( 95% CI 68.49-81.59), negative predictive value (NPV) of 83.18%( 95% CI 78.95-86.70) and diagnostic accuracy of 80.53%( 95% CI 75.91-84.61)with p-value less than 0.001. The number of negative slide tests positively correlated with the Peritoneal Adhesion Index score (r = 0.662, p < 0.001) and also with increasing operative time and intraoperative blood loss. Accuracy and positive predictive value of the test were significantly higher in patients with a history of abdominal surgeries, endometriosis and PID.
Conclusion:
Visceral slide test is an easy, rapid, non-invasive and reliable screening test to predict abdominal adhesions in women undergoing gynecological surgery. The presence of risk factors for adhesions increases the accuracy of the test.
Oral communication abstractsage (RR: 1.07; p < 0.0001), diabetes (RR: 2.84; p < 0.0001), and poverty >30% (RR: 1.5; p = 0.043) were independent predictors of death in pregnant women with COVID-19. Conclusions: Our study shows that co-morbidities and social factors worsen the course of COVID-19 during pregnancy. It is critical for Mexico and Latin America to develop health strategies to tackle the alarming increase in the maternal death rate. OC10.05 *Increased nuchal translucency in congenital heart defects: associations with mortality
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