To Associate The Fetal Distress, IUD and IUGR Observed In Normal, Diabetic and Hypertensive Pregnancies

Farrah  Shams; Fawad Ali; Nawaz  Samoo; Farah Malik; Uzma  Asif; Alia Gul; Aisha Saddique

doi:10.54393/pbmj.v5i1.256

Authors

Farrah Shams Dow University of Health Science, Batterjee Medical College, Jeddah, Saudi Arabia
Fawad Ali Department of Biotechnology, Bacha Khan University Charsadda, KP, Pakistan
Nawaz Samoo Department of Medicine, CPSP Pakistan, Batterjee Medical College, Saudi Arabia
Farah Malik Liquat College of Medicine And Dentistry, Karachi, Pakistan
Uzma Asif Department of Biochemistry, Batterjee Medical College, Saudia Arabia
Alia Gul Department of Botany, Hazara University Mansehra, KPK, Pakistan
Aisha Saddique Department of Microbiology, Women University, Mardan, Pakistan

DOI:

https://doi.org/10.54393/pbmj.v5i1.256

Keywords:

Gestational Hypertension, Gestational Diabetes, Placental Insufficiency and Apgar score.

Abstract

To associate the fetal distress, IUD and IUGR observed in normal, diabetic and hypertensive pregnancies. Study Design: Cross sectional study with non probability purposive sampling was done. Place and Duration of Study: Institute Basic Medical Sciences, Dow university of Health Sciences, Karachi, from 2011-2013. Method: Cross sectional study with non probability purposive sampling was done.The patients were identified and selected through OPDs of two different hospitals in public and private sector. A total of 150 patients were selected, on the basis of history and clinical examination they were divided into three groups, Control (A), Diabetic (B), and Hypertensive (C), each having 50 individuals. Ultrasound and cardiac tocography (CTG) for all patients was carried out. The newborn was examined most of the time by a doctor from pediatric ward and, apgar scoring recorded at 1^st min, 5^th min and 10^th min of birth. The data was entered and analyzed on SPSS version 16.0. Mean ± standard deviations was computed for the quantitative variables like Apgar score, by using ANOVA. P-value was determined at 95%confidence interval and <0.05 taken as significant. Qualitative variables such as fetal distress, IUGR and IUD were presented by frequencies and percentages Results:Fetal distress was highest 46% in hypertensive group(p-0.005). IUGR was seen highest 6% in hypertensives(p-0.005). IUD was observed 10% in diabetic group (p-0.005). Results found by ultrasound scans were 92 % normal in control group, 68 % in hypertensive and 54 % in diabetic group.Mean Apgar score of baby in 1 minute was same in all the three groups. Conclusion:It is confirmed by this study that there are more no of cases with poor outcome of pregnancy in diabetic and hypertensive as compared to control group.

References

Placental Insufficiency. Encyclopedia for Medical Reference: reviewed by Audra Robertson; 2006.

Expert committee on the diagnosis and classification of diabetes mellitus. report of the expert committee on the classification of diabetes mellitus: Diabetes Care.2003; 26(sup-1):5-20. https://doi.org/10.2337/diacare.26.2007.S5

American Diabetes Association: Gestational diabetes mellitus (position statement): Diabetes Care.2004; 27(sup-1):88-90.

https://doi.org/10.2337/diacare.27.2007.S88

Seely EW, Solomon CG. Insulin resistance and its potential role in pregnancy-induced hypertension: J Clin Endocrinol Metab.2003; 88:2393-8.

https://doi.org/10.1210/jc.2003-030241

Schmidt MI, Duncan BD, Reichelt AJ, Branctein L, Matos MC, Forth A, et.al. Gestational diabetes mellitus diagnosed with a 2hr 75-gm oral glucose tolerance test and adverse pregnancy outcomes: Diabetes Care. 2001; 24:1151-5. https://doi.org/10.2337/diacare.24.7.1151

Catalano P, Huston L, Amini SB, Kalhan S. Longitudinal changes in glucose metabolism during pregnancy in obese women with normal glucose tolerance and GDM: Am J Obstet Gynecol.1999;180:903-916. https://doi.org/10.1016/S0002-9378(99)70662-9

Dabelea D, Hanson RL, Lindsay RS, Pettitt DJ, Imperatore G, Gabir MM, Roumain J, Bennet PH, Knowler WC. Intrauterine exposure to diabetes conveys risk for type 2 diabetes and obesity: a study of discordant sib ship. Diabetes.2000; 49:2208-11

https://doi.org/10.2337/diabetes.49.12.2208

Joey PG, Barbara TA, Maria TL, William AB, Raouf AK. Pathophysiology of hypertension during preeclampsia linking placental ischemia with endothelial dysfunction: Hypertension .2001; 38(2):718-22. https://doi.org/10.1161/01.HYP.38.3.718

Arnadottir GA, Geirsson RT, Arngrimsson R, Jonsdottir LS, Olafsson O, Cardiovascular death in women who had hypertension in pregnancy : BJOG.2005;112:286-92. https://doi.org/10.1111/j.1471-0528.2004.00396.x

Ray JG, Vermeulen MJ, Schull MJ, Redelmeier DA. Cardiovascular health after maternal placental syndromes: Lancet. 2005; 366:1797-1803.

https://doi.org/10.1016/S0140-6736(05)67726-4

Smith GC, Pell JP, Walsh D. Pregnancy complications and maternal risk of ischemic heart disease: Lancet.2001; 357:2002-6.

https://doi.org/10.1016/S0140-6736(00)05112-6

Svein R, Lorentz MI. Pregnancy induced hypertension in women who were born small: Hypertension.2007; 49; 806-12.

https://doi.org/10.1161/01.HYP.0000259924.74947.aa

Germain AM, Romanik MC, Guerra I, Solari S Reyes MS, Johnson RJ, Price K, Karumanchi SA, Valdes G. Endothelial dysfunction-a link among preeclampsia, recurrent pregnancy loss, and future cardiovascular events: Hyperytension.2007; 49:90-5. https://doi.org/10.1161/01.HYP.0000251522.18094.d4

Udiana A, Jain ML. Morphological study of placenta in pregnancy induced hypertension with its clinical relevance: J Anat. Soc. India.2001; 50(1):24-7.

Marina kos, Bernard Czernobilsky, Ljiljana Hlupic, Kristian Kunjko: Pathological changes in placenta from pregnancies with eclampsia and preeclampsia with emphasis on persistence of endovascular trophoblastic plugs. Croat Med J.2005; 46(3):404-9.

Sheffield JS, Butler-Koster EL, Casey BM, Mcintire DD, Leveno KJ. Maternal diabetes mellitus and infant malformation: Obstet Gynecol. 2002; 100:925-30. https://doi.org/10.1016/S0029-7844(02)02242-1

Margaret J E. Diabetes and pregnancy: a review of pathology: British Journal of Diabetes & Vascular Diseases.2009; 9:201-6.

https://doi.org/10.1177/1474651409344924

Zhou Y, McMaster M, Woo K, Janatpour M, Perry J, Karpanen T, Alitalo K, Damsky C, Fisher SJ. Vascular endothelial growth factor ligands and receptor that regulate human cytotrophoblasts survival are dys-regulated in severe preeclampsia and hemolysis, elevated liver enzymes and low platelets syndrome: Am J Pathol .2002; 160:1405-23. https://doi.org/10.1016/S0002-9440(10)62567-9

Udiania A, Bhagwat S, Mehta C D .Relation between placental surface area, infarction and fetal distress in pregnancy induced hypertension with its clinical relevance: J Anat Soc India. 2004; 53(1):27-30.

Majumdar S, Dasgupta H, Bhattacharya K et.al. A Study of placenta in normal & hypertensive pregnancies: J Anat Soc India. 2005; 54(2):1-9