1.Association of intrapartal maternal blood glucose control and neonatal hypoglycemia in a private tertiary hospital.
De Leon Maria Edwardina G. ; Gonzaga Zarinah R.
Philippine Journal of Obstetrics and Gynecology 2016;40(1):1-8
OBJECTIVE: Diabetes in pregnancy is associated with maternal and fetal risks that include maternal hyperglycemia and neonatal hypoglycemia. Intrapartal plasma glucose concentration has a stronger association with decreased neonatal hypoglycemia paralleled with antepartum plasma glucose levels. The objective of the study is to determine the association between intrapartal glucose monitoring and neonatal hypoglycemia.
METHODS: This is a retrospective cohort study that involves parturients of any age with term gestation (>37 weeks) with gestational type or overt type of diabetes mellitus, either insulin-requiring or on medical nutrition therapy, with or without mean capillary blood glucose levels during labor. Multiple logistic regression was used for analysis, which quantifies the magnitude of association between maternal blood glucose control and neonatal hypoglycemia adjusted for significant confounders.
RESULTS: The incidence of diabetes among pregnants in this private tertiary hospital over the study period was 7.82%. Most of the diabetic parturients were primigravid, with gestational type of diabetes mellitus, and on medical nutrition therapy. More than half were referred to an endocrinologist intrapartum. The incidence of maternal hyperglycemia intrapartum is 33%. The birthweights of the neonates ranged from 2095 to 5250 grams. Among the diabetic parturients, the incidence of neonatal hypoglycemia is 10%. There was no significant association between neonatal hypoglycemia and intrapartummaternal hyperglycemia (p=0.05).
CONCLUSION: There is no significant association between intrapartum maternal hyperglycemia and development of neonatal hypoglycemia. Antepartum and intrapartum management of maternal hyperglycemia did not appear to be associated with the development of neonatal hypoglycemia. A standardized institutional management protocol on glucose monitoring and control among diabetic parturients is strongly suggested.
Human ; Female ; Adult ; Pregnancy ; Insulin ; Blood Glucose ; Endocrinologists ; Hyperglycemia ; Hypoglycemia ; Birth Weight ; Gravidity ; Nutrition Therapy
2.Characteristics of COVID-19 positive pregnant patients admitted in a private tertiary hospital and their maternal and neonatal outcomes
Josephine Alexandra D. Lim ; Zarinah G. Gonzaga ; Mariles R. Hernandez‑Nazal
Philippine Journal of Obstetrics and Gynecology 2022;46(2):69-79
Introduction:
The severe acute respiratory syndrome coronavirus 2 pandemic has had profound effects globally. Historical experience with previous Coronaviruses has shown increased maternal and perinatal morbidity and mortality, theoretically secondary to the physiologic changes of pregnancy. As of August 2021, the Philippines is the 23rd top country worldwide in terms of total number of cases, yet there remains to be a sparse pool of information both internationally and locally
Objectives:
This study aims to present the prevalence, clinical characteristics, as well as the neonatal, obstetric, and maternal outcomes of all pregnant women admitted in the institution who had active or previous COVID‑19 infection
Methodology:
Retrospective review of data using the hospital’s health information system was utilized. Within the study period, all admitted obstetric patients who had at least one positive result in a RT‑PCR naso‑oropharyngeal swab for SARS‑CoV‑2 were included in this study and categorized into: (1) symptomatic, (2) recovered, and (3) asymptomatic
Results:
A total of 48 patients were included in the study, where prevalence of COVID‑19 in pregnancy was 3.65%. Results showed that most patients were in the third trimester, and contrary to the non‑pregnant population, majority (60.41%) did not have comorbidities. Most remained asymptomatic (33.33%) or had mild symptoms (18.75%), and underwent abdominal delivery (50%) for obstetric indications. COVID‑19 status was not associated with adverse obstetric outcomes in this study population, but had significant association with preterm birth (p=0.019) and NICU admission (P=<0.001
Conclusion
Overall, most cases were asymptomatic and had good prognosis even with the adaptations a pregnant woman undergoes. In addition, neonatal outcomes were generally good regardless of the association with preterm birth and NICU admission. Lastly, there was no appreciated evidence for vertical transmission
Respiratory Distress Syndrome
;
Cesarean Section
;
Coronavirus
;
COVID-19
;
Intensive Care Units, Neonatal
;
Pandemics
;
Pregnant Women
;
SARS-CoV-2