1.Glycated haemoglobin is a good predictor of neonatal hypoglycaemia in pregnancies complicated by diabetes
Kulenthran ARUMUGAM ; Nathira ABDUL MAJEED
The Malaysian Journal of Pathology 2011;33(1):21-24
We investigated the usefulness of a single value of maternal HbA1c in late pregnancy as a predictor
for neonatal hypoglycaemia and secondly, to fi nd the appropriate threshold value. A prospective
analysis of the HbA1c concentration between 36 to 38 weeks of gestation in 150 pregnant mothers
with either pre-existing or gestational diabetes was performed. At delivery, glucose levels in the
cord blood were analysed. Neonatal hypoglycaemia was defi ned as a blood sugar level of < 2.6
mmol/l. Receiver operator characteristic curve was constructed to evaluate the value of HbA1c
concentration in predicting hypoglycaemia. There were 16 foetuses who were hypoglycaemic at
delivery. The area under the ROC curve for predicting neonatal hypoglycaemia was 0.997 with a
95% confi dence interval of 0.992 to 1, a very good prediction rate. The optimal threshold value for
HbA1c in predicting hypoglycaemia in the foetus was 6.8% (51 mmol/mol). HbA1c level in late
pregnancy is a good predictor for hypoglycaemia in the newborn.
2.Prognostic factors influencing pregnancy rate after stimulated intrauterine insemination.
Paul Y S Tay ; V R Mohan Raj ; A Kulenthran ; O Sitizawiah
The Medical journal of Malaysia 2007;62(4):286-9
To determine the prognostic factors such as age, diagnosis, number of cycle attempts and semen parameters on the pregnancy rate of controlled ovarian hyperstimulation (COH) /intrauterine insemination (IUI). Three hundred and seventeen women who underwent 507 consecutive COH/IUI cycles were recruited from 1st January 2002 to 31st December 2005 inclusively. This retrospective study was done in University Malaya Medical Centre, a tertiary care academic centre. The main outcome measure was pregnancy rate according to age, infertility diagnosis, duration of infertility, semen parameters, and the number of treatment cycles. The overall pregnancy rates were 16.9% per cycle and 25.9% per couple. Pregnancy rates decreased with advancing maternal age. Pregnancy rate was also significantly lower in patient with postwash total motile sperm count (TMSC) < or = 20 million/ml compared to those with TMSC >20 million/ml. The cumulative pregnancy rates varied greatly by diagnosis from 16% for patients with male factor infertility to 60% for patients with ovulatory disorder. Pregnancies among patients with male infertility, tubal factors infertility and endometriosis were achieved during the first three cycles. There is a clear age-related decline in fecundity associated with COH/IUI treatment. Women of > 40 years old, couple with postwash TMSC < or = 20 million/ml, severe endometriosis and tubal factors have a particularly poor prognosis.
Pregnancy
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Infertility
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Intrauterine artificial insemination
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Diagnostic