Keywords : pregnancy
Basrah Journal of Surgery,
2011, Volume 17, Issue 1, Pages 0-0
Rabia A Alkaban* & Methal A AL-Rubaee@
*MB,ChB. @MB,ChB, DGO, CABOG, Department of Obstetric & Gynecology, Medical College,
University of Basrah
This is a case-control comparative study carried out over the period (July 2007-July
2008) to identify the frequent type of D.M., analyze demographic features of diabetic
cases as well as to identify maternal, fetal & neonatal complications of D.M. during
This study included 160 diabetic pregnant women as (cases) compared to 180 nondiabetic
pregnant women as (control) who were admitted to three known hospitals with
obstetrical & Gynecology department during same period of study. Such controls had
approximated age & parity to that of cases.
Type 2 DM was the commonest type among cases who tend to be more advanced in
their age with higher BMI compared to controls. Three major risk factors that predispose
to develop GDM were family history of type 2 or GDM, advanced maternal age & obesity.
Diabetic pregnancy was more likely complicated by abortions, hypertensive disorders,
polyhydramnious and preterm delivery with high C/S rate as well as P.P.H. & birth tract
injury in comparison to controls. Cephalo-pelvic disproportion consequent to
macrosomia was main indication for C/S in diabetic cases in whom not only macrosomic
newborns were more but also stillbirth rate was higher with lower Apgar score & more
admission to NICU.
Diabetic newborns were more likely to be affected by RDS, hypoglycemia & congenital
In conclusion, D.M. is a major medical disorder that exhibit burden on health of both
mother & fetus with high maternal morbidity, prenatal & neonatal morbidity & mortality.
Basrah Journal of Surgery,
2005, Volume 11, Issue 1, Pages 20-31
Pregnancy is the only physiologic condition that is treated in the hospital environment. All other medical conditions that are treated in such a setting are pathologic. When a pregnant patient develops a pathologic condition that requires surgical intervention, it is imperative to remember that the lives of two individuals are involved, the mother and the foetus. In such settings it is essential that the treating surgeon understand the physiologic states of these two individuals as an interdependent symbiotic relationship. Not only must appropriate maternal care be rendered, prevention of foetal complications is also desirable.
Changing physiology and anatomical landmarks frequently cause confusion and delay in dealing with surgical problems in the pregnant patient. Both symptoms and signs could be modified, contributing to delay in seeking medical attention, timely referral for surgical evaluation, or the initiation of appropriate diagnostic procedures.
Surgery during pregnancy is an uncommon event, but one that creates a great deal of anxiety for both patients and medical practitioners. Delays in diagnosis and definitive treatment represent the most significant risk for untoward outcome in both the mother and the foetus.
Laparoscopic surgery has rapidly and widely spread in the management of wide abdominal conditions, which resulted in several significant benefits to the non-gravid patients. Pregnant patients and their foetuses could drive the same benefits from minimally invasive surgery, which are received by the non-gravidas. However, due to the several physiological and anatomical factors encountered during pregnancy many issues need to be thought about and dealt with.
Optimal surgical treatment of the pregnant patient will be realized when there is collaboration between the various subspecialties involved in her care.
Basrah Journal of Surgery,
2005, Volume 11, Issue 1, Pages 50-59
We tested the hypothesis that the plasma lipid and lipoproteins concentrations are increased markedly in women with pregnancy induced hypertension (PIH) relative to women with uncomplicated pregnancy and that these lipids decrease postpartum and to clarify the relation of lipid profile changes with the severity of pregnancy induced hypertension.
This study is a prospective, case-control study conducted at Basrah Maternity and Child Hospital extended through a period of 12 months from the first of August 2000 till the first of August 2001.
Pre-labor venous blood samples were collected for 90 women with pregnancy-induced hypertension and 110 women with normal uncomplicated pregnancy with an age range (16-40) years and gestational age range (34-42) weeks after 12 hours fasting. Venous blood samples were also collected from only 30 women with PIH and 30 women with normal uncomplicated pregnancy after 24-48 hours postpartum. Serum was analyzed for concentrations of triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and very low-density lipoprotein cholesterol (VLDL-C).
Pre-labor serum (TG), (TC), (LDL-C) and (VLDL-C) were increased in women with PIH relative to uncomplicated pregnancies respectively P value (<0.001). (HDL-C) concentration does not differ between studied groups (P = 0.1). Concentrations of all lipids decreased significantly (P value <0.001) in both groups within the first 24-48 hours postpartum. However the levels of these lipids remained higher in women with PIH but were statistically not significant. Serum triglyceride and VLDL concentrations but not total cholesterol, HDL-C and LDL-C were significantly higher in severe PIH group in comparison with mild PIH. There was no correlation between the age, parity and the lipid profiles changes in both groups. There was a positive correlation between each of the (TG), (TC), (LDL-C) and (VLDL-C). (HDL-C) does not correlate significantly with other different types of lipid. In conclusion, plasma lipids and lipoproteins but not HDL-C are increased in PIH relative to normal pregnancy and hypertriglyceridemia found in severely PIH may contribute to endothelial dysfunction in PIH.