| Obstetric problems in diabetic pregnancy - The role of fetal hypoxia. | |
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MedLine Citation:
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PMID: 20832744 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Perinatal mortality has not decreased over the last two decades in pregestational diabetic pregnancies. Stillbirth rate is 4-6 times and neonatal mortality 2-4 times higher in diabetic than in non-diabetic pregnancies despite modern electronic fetal surveillance methods. Majority of late stillbirths are "unexplained", many of which are presumably caused by fetal hypoxia. Both experimental and clinical studies have shown that fetal hyperglycaemia and hyperinsulinaemia can independently cause fetal hypoxia, which ultimately can lead to fetal death. Poor glycaemic control is associated with perinatal complications. Sharp increases in amniotic fluid erythropoietin levels indicate fetal hypoxia in diabetic pregnancy. Fetal erythropoietin concentrations correlate directly with maternal HbA(1c) levels. It is therefore important to maintain near-normal glycaemic level throughout pregnancy. Measurement of amniotic fluid erythropoietin level is a new way to detect fetal hypoxia antenatally. Sufficiently large controlled studies are needed before definitive answer of the clinical utility of amniotic fluid erythropoietin measurements in diabetic pregnancies can be determined. |
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Authors:
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Kari A Teramo |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Best practice & research. Clinical endocrinology & metabolism Volume: 24 ISSN: 1532-1908 ISO Abbreviation: Best Pract. Res. Clin. Endocrinol. Metab. Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-09-13 Completed Date: 2011-01-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101120682 Medline TA: Best Pract Res Clin Endocrinol Metab Country: Netherlands |
Other Details:
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Languages: eng Pagination: 663-71 Citation Subset: IM |
Copyright Information:
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2010 Elsevier Ltd. All rights reserved. |
Affiliation:
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Department of Obstetrics and Gynaecology, University Central Hospital, Helsinki, Finland. kari.teramo@hus.fi |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Amniotic Fluid Erythropoietin / analysis Female Fetal Hypoxia / diagnosis* Hemoglobin A, Glycosylated / analysis Humans Infant Mortality Infant, Newborn Pregnancy Pregnancy Complications / diagnosis* Pregnancy in Diabetics / physiopathology* Stillbirth / epidemiology |
| Chemical | |
Reg. No./Substance:
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0/Hemoglobin A, Glycosylated; 0/hemoglobin A1c protein, human; 11096-26-7/Erythropoietin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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