RESUMEN
The goal of the treatment of infertility is to apply therapeutic techniques to patients in a safe manner and at the same time increase the chances for conceiving and delivering healthy babies: basic and clinical research is more and more finalized directed to these goals. The conference "Advances in Infertility Treatment" held in Fort Lauderdale, Florida on January 24-26, 2002 covered many clinical and research aspects of this important therapeutic area. Important discussed issues included the impact of age, lifestyle, and the genetic set-up of patients in the pathogenesis and development of infertility-causing disorders such as male reproductive dysfunction, polycystic ovary syndrome, and ovarian failure. New ovulation induction regimens that may optimize, reduce complications, and lower costs of ovarian stimulation procedures and of assisted reproduction in general were presented. This was the 5th Ferring Pharmaceuticals Conference in the area of reproductive medicine held in Florida.
Asunto(s)
Infertilidad/terapia , Aborto Espontáneo/prevención & control , Costos y Análisis de Costo , Femenino , Florida , Humanos , Infertilidad Femenina/etiología , Infertilidad Femenina/terapia , Infertilidad Masculina/terapia , Hormona Luteinizante/administración & dosificación , Masculino , Menotropinas , Oocitos/fisiología , Inducción de la Ovulación/economía , Inducción de la Ovulación/métodos , Síndrome del Ovario Poliquístico/complicaciones , Embarazo , Diagnóstico Preimplantación , Técnicas Reproductivas Asistidas , Inyecciones de Esperma IntracitoplasmáticasRESUMEN
OBJECTIVE: To assess the efficacy of a co-program of care in gestational diabetes conducted by the obstetrical and endocrinological units of the Rennes South Hospital (Hopital Sud) and the possibility of adapting obstetrical care to existing risk factors. PATIENTS AND METHODS: A retrospective analysis was made of 200 cases of gestational diabetes diagnosed between January 1993 and December 1996 in the obstetrical units. RESULTS: Instrumental extraction and cesarean section were required for 13.5% and 20.5% of the deliveries respectively. Shoulder dystocia occurred in 2%. 19.9% of the infants had macrosomia and 5. 3% were small for gestational age. Neonatal morbidity required transfer to the pediatric intensive care unit for only 2.9% of the infants. Frequency of cesarean section and macrosomia correlated with poor blood glucose control and excess maternal weight for gravidic hypertension. At 3 months post-partum, glucose intolerance and non-insulin-dependent diabetes were diagnosed in 13% and 2% respectively. CONCLUSION: Systemic screening and obstetrical and endocrinological care allowed patients to prevent maternal and fetal complications in gestational diabetes and to initiate hygiene and dietary habits for the prevention of post-partum non-insulin-dependent diabetes. Obstetrical care can be adapted to risk factors such as overweight, late screening or poor blood glucose control.
Asunto(s)
Diabetes Gestacional/terapia , Endocrinología , Departamentos de Hospitales , Servicio de Ginecología y Obstetricia en Hospital , Grupo de Atención al Paciente , Índice de Masa Corporal , Cesárea , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Gestacional/diagnóstico , Distocia/epidemiología , Femenino , Retardo del Crecimiento Fetal/epidemiología , Macrosomía Fetal/epidemiología , Intolerancia a la Glucosa , Humanos , Recién Nacido , Cuidado Intensivo Neonatal , Embarazo , Estudios Retrospectivos , HombroRESUMEN
The aim of this work was to study the predictive value of 50 gram glucose O'Sullivan test for systematic screening of gestational diabetes. To confirm the diagnostic the test positivity was controlled by a 100 g, 3 hours oral glucose tolerance test. During a 12-month period, 751 women were included in the 7th month pregnancy consultation. The O'Sullivan test was positive in 18% of cases. The oral glucose tolerance test confirmed the diagnostic in 14% of these positive tests. The frequency of gestational diabetes was about 2.5% in this population. We compared then the results of the test with the other available screening modes. For this purpose, we analysed retrospectively 50 gestational diabetes diagnosed during the same time in the entire pregnant population of the clinic. In our experience, the O'Sullivan's test is a reliable and useful test. It is easy to perform. Less women are selected than in analysis of risk factors (18% versus > 30%), and with better sensitivity.