Influence of polyhydramnios on perinatal outcome in pregestational diabetic pregnancies

Idris, N.; Wong, Shiu F.; Thomae, Michael; Gardener, Glenn; McIntyre, David

doi:10.1002/uog.7676

Cited by 44 publications

(34 citation statements)

References 19 publications

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“…Idris et al revealed that pregestational diabetic pregnancy with polyhydramnios was associated with poor diabetic control and resulting with significant increase in adverse perinatal outcome in these pregnancies, apart from a higher iatrogenic preterm birth rate. 18 In present study, there was no significant difference regarding fetal distress parameters and poor fetal outcome between groups even though higher HbA1c rates in pregestational diabetic patients. We think that in studies with larger numbers, polyhydramnios scores may be different.…”

Section: Discussioncontrasting

confidence: 51%

Gestational diabetes mellitus is as innocent as you think?

Uysal¹,

Kütük²

2018

Int J Reprod Contracept Obstet Gynecol

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The antenatal follow-up in diabetic pregnant women is important to control blood glucose levels, treat chronic complications and to monitor the fetus. In addition to routine pregnancy antenatal follow up, glucose impairment is the most focused issue to manage and identify the complications of pregnancy in GDM patients.It is well known that pregestational DM has higher congenital fetal malformations including caudal ABSTRACT Background: We aimed to compare fetal outcomes, fetal hypoxia, acidemia and maternal chracteristics including hemoglobin A1c, doppler indices between gestational diabetes mellitus (GDM) and pregestational diabetes mellitus (DM) among pregnant women treated with insulin. Methods: Data of pregnant patients with diagnosis of pregestational diabetes (type 1 and 2) and GDM who were treated with insulin (GDM A2 in White classification) was retrospectively collected and compared. Patients with active chronic systemic disease, multiple pregnancies, lost to follow up and detected fetal malformations were exluded. Maternal characteristics, umbilical doppler indices and amnion fluid index, gestational age at delivery, delivery characteristics (including vaginal delivery, or cesarean section) and newborn characteristics such as birth weight, Apgar score and umblical cord pH were all recorded. Results: A total of 130 patients (67 patients with GDM and 63 pregestational DM) were recruited to the study. There were no significant difference regarding type of delivery, fetal birth weight, umbilical cord Hb and gestational birth age. No other significant difference in frequency of low Apgar scores and fetal acidosis or metabolic acidosis were reported. HbA1c and blood glucose levels and insulin dosage were significantly statistically higher in pregestational group. Conclusions: The frequency of fetal distress parameters and poor fetal outcome were similar between groups although pregestaional diabetic patients had higher HbA1c rates. Therefore, patients with GDM (A2) should be followed up as closely as pregestational (overt) diabetic patients.

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Section: Discussioncontrasting

confidence: 51%

Gestational diabetes mellitus is as innocent as you think?

Uysal¹,

Kütük²

2018

Int J Reprod Contracept Obstet Gynecol

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“…Maternal diabetes mellitus, due to fetal polyuria, isassociated with polyhydramnios which in return is associated with pre-term labour which could have been the closest reason in our case that led to the delivery of a still born fetus at the gestational age of 22 weeks (8). This case report in particular bear evidence to the devastating complications, uncontrolled pre-gestational diabetes can impose on a developing fetus and the overall outcome of a pregnancy.…”

Section: Discussionmentioning

confidence: 70%

Caudal Regression Syndrome: A Journey from Sweet to Sour: A Unique Complication of Maternal Diabetes Mellitus: A Case Report of a Still Born Fetus

2016

IJSR

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“…An expression of AQPs 1, 3, 8, and 9 in chorio-amniotic membranes has already been reported in healthy pregnancy (10); an increase in their expression has been observed in idiopathic polyhydramnios (12)(13)(14). In addition, polyhydramnios is known to frequently be associated with diabetes (5,6). On the other hand, the role of the fetal membranes via the AQPs in regulating the amniotic volume in diabetic pregnant women has never been closely investigated, except for one recent study on a small sample, which did not allow for the different types of diabetes encountered during pregnancy, links with certain clinical or therapeutic data, or molecular and cellular studies of insulin involvement in the amnion (16).…”

Section: Discussionmentioning

confidence: 96%

“…Among these, fetal hyperglycemia responsible for polyuria through an osmotic effect is the one most commonly hypothesized. Diabetic children with macrosomia (defined by a weight Ͼ 4000 g at term gestation or Ͼ the 95th percentile for gestational age body mass index [BMI]) also have increased heart rate and plasma volume, which increases glomerular filtration rate and thereby urine production (5,6).…”

mentioning

confidence: 99%

Aquaporins and Fetal Membranes From Diabetic Parturient Women: Expression Abnormalities and Regulation by Insulin

Bouvier

Rouzaire

Marceau

et al. 2015

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context: During pregnancy, aquaporins (AQPs) expressed in fetal membranes are essential for controlling the homeostasis of the amniotic volume, but their regulation by insulin was never explored in diabetic women. Objective:The aim of our study was to investigate the involvement of AQPs 1, 3, 8, and 9 expressed in fetal membranes in diabetic parturient women and the control of their expression by insulin. Design and Participants:From 129 fetal membranes in four populations (controls, type 1, type 2 [T2D], and gestational diabetes [GD]), we established an expression AQP profile. In a second step, the amnion was used to study the control of the expression and functions of AQPs 3 and 9 by insulin. Main Outcomes and Measures:The expression of transcripts and proteins of AQPs was studied by quantitative RT-PCR and ELISA. We analyzed the regulation by insulin of the expression of AQPs 3 and 9 in the amnion. A tritiated glycerol test enabled us to measure the impact of insulin on the functional characteristics. Using an inhibitor of phosphatidylinositol 3-kinase, we analyzed the insulin intracellular signaling pathway. Results:The expression of AQP3 protein was significantly weaker in groups T2D and GD. In nondiabetic fetal membranes, we showed for the amnion (but not for the chorion) a significant repression by insulin of the transcriptional expression of AQPs 3 and 9, which was blocked by a phosphatidylinositol 3-kinase inhibitor. Conclusion:In fetal membranes, the repression of AQP3 protein expression and functions observed in vivo is allowed by the hyperinsulinism described in pregnant women with T2D or GD. (J Clin Endocrinol Metab 100: E1270 -E1279, 2015)

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Influence of polyhydramnios on perinatal outcome in pregestational diabetic pregnancies

Abstract: ABSTRACT

Cited by 44 publications

References 19 publications

Gestational diabetes mellitus is as innocent as you think?

Gestational diabetes mellitus is as innocent as you think?

Caudal Regression Syndrome: A Journey from Sweet to Sour: A Unique Complication of Maternal Diabetes Mellitus: A Case Report of a Still Born Fetus

Aquaporins and Fetal Membranes From Diabetic Parturient Women: Expression Abnormalities and Regulation by Insulin

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