Diagnostic of gestational diabetes mellitus and the prevalence of LGA (Large for Gestational Age)

Summary Objectives: Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance, first time detected in pregnancy. Early diagnosis of the disease may reduce fetal exposure to maternal hyperglycemia and decrease the risk of LGA. The aim of the study was to examine the influence of time and diagnostic method of GDM on the prevalence of LGA and pregnancy outcome among patients with gestational diabetes. Material and Methods: The study was conducted among 211 women with gestational diabetes mellitus, the patients of 1st Clinic of Obstetrics and Gynecology at the Medical University in Warsaw. We have reviewed the results of fasting plasma glucose, 50-g glucose screening test (GCT) and 2 hour 75-g glucose tolerance test in GDM patients with LGA and eutrophic newborns. The t-student or the Mann-Whitney test was used in order to compare both groups.

Diagnostic of gestational diabetes mellitus and the prevalence of LGA (Large for Gestational Age)

Summary Objectives: Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance, first time detected in pregnancy. Early diagnosis of the disease may reduce fetal exposure to maternal hyperglycemia and decrease the risk of LGA. The aim of the study was to examine the influence of time and diagnostic method of GDM on the prevalence of LGA and pregnancy outcome among patients with gestational diabetes. Material and Methods: The study was conducted among 211 women with gestational diabetes mellitus, the patients of 1st Clinic of Obstetrics and Gynecology at the Medical University in Warsaw. We have reviewed the results of fasting plasma glucose, 50-g glucose screening test (GCT) and 2 hour 75-g glucose tolerance test in GDM patients with LGA and eutrophic newborns. The t-student or the Mann-Whitney test was used in order to compare both groups.

Posture and low back pain during pregnancy — 3D study

Objectives: Back pain is a common complaint of pregnant women. The posture, curvatures of the spine and the center of gravity changes are considered as the mechanisms leading to pain. The study aimed to assess spinal curvatures and static postural characteristics with three-dimensional surface topography and search for relationships with the occurrence of back pain complaints among pregnant women. Material and methods: The study was conducted from December 2012 to February 2014. Patients referred from University Clinic of Gynecology and Obstetrics were examined outpatient at the Posture Study Unit of Department of Orthopaedics and Traumatology. Sixty-five women at 4–39 weeks of pregnancy were assessed and surveyed with Oswestry Disability Index; posture was evaluated using surface topography. Results: The study confirmed that difficulties in sitting and standing are significant in the third trimester of the pregnancy. The overall tendency for significant lumbar curvature changes in pregnant women was not confirmed. Major changes in sagittal trunk inclination in relation to the plumb line were not observed in the study group. Conclusions: The issue regarding how the pregnancy causes changes in spinal curvature and posture remains open for further studies. Presented method of 3D surface topography can reveal postural changes, but that requires several exams of each subject and strict follow-up of the series of cases

Outcomes of Sutureless Iris-Claw Lens Implantation

Purpose. To evaluate the indications, refraction, and visual and safety outcomes of iris-claw intraocular lens implanted retropupillary with sutureless technique during primary or secondary operation. Methods. Retrospective study of case series. The Haigis formula was used to calculate intraocular lens power. In all cases the wound was closed without suturing. Results. The study comprised 47 eyes. The mean follow-up time was 15.9 months (SD 12.2). The mean preoperative CDVA was 0.25 (SD 0.21). The final mean CDVA was 0.46 (SD 0.27). No hypotony or need for wound suturing was observed postoperatively. Mean postoperative refractive error was −0.27 Dsph (−3.87 Dsph to +2.85 Dsph; median 0.0, SD 1.28). The mean postoperative astigmatism was −1.82 Dcyl (min −0.25, max −5.5; median −1.25, SD 1.07). Postoperative complications were observed in 10 eyes. The most common complication was ovalization of the iris, which was observed in 8 eyes. The mean operation time was 35.9 min (min 11 min, max 79 min; median 34, SD 15.4). Conclusion. Retropupilary iris-claw intraocular lens (IOL) implantation with sutureless wound closing is an easy and fast method, ensuring good refractive outcome and a low risk of complication. The Haigis formula proved to be predictable in postoperative refraction

Erratum: 14 Years of Polish Experience in Non-Invasive Prenatal Blood Group Diagnosis

<b><i>Background:</i></b> Blood cell antigens may cause maternal alloimmunization leading to fetal/newborn disorders. Non-invasive prenatal diagnostics (NIPD) of the blood group permits the determination of feto-maternal incompatibility. <b><i>Aim: </i></b>To evaluate 14 years of blood group NIPD at the Institute of Hematology and Transfusion Medicine (IHTM) in Warsaw. <b><i>Methods: </i></b>Plasma DNA from 536 RhD-negative, 24 Rhc-negative, 26 RhE-negative, 43 K-negative, and 42 HPA-1a-negative pregnant women was examined by real-time PCR to detect <i>RHD, RHCE*c, RHCE*E</i>, <i>RHCE*C,</i><i>KEL*01</i> and <i>HPA*1A, </i>respectively. We tested for <i>CCR5</i>, <i>SRY</i> or bi-allelic polymorphisms and quantified the total or fetal DNA. <b><i>Results:</i></b> The results of fetal antigen status prediction by NIPD in all but one case (false-positive result of <i>KEL*01</i>) were correct taking neonate serology as a reference. It was confirmed that all negative results of NIPD contained fetal DNA except for four cases where there was no difference between the parents' polymorphisms. <b><i>Conclusions:</i></b> A fetal genotype compatible with the mother was determined in 25% of all pregnancies tested at the IHTM for the fetal blood group. These cases were not at risk of disease, so it was possible to avoid invasive procedures

Randomized Trial of Fetal Surgery for Severe Left Diaphragmatic Hernia

BACKGROUND Observational studies have shown that fetoscopic endoluminal tracheal occlusion (FETO) has been associated with increased survival among infants with severe pulmonary hypoplasia due to isolated congenital diaphragmatic hernia on the left side, but data from randomized trials are lacking. METHODS In this open-label trial conducted at centers with experience in FETO and other types of prenatal surgery, we randomly assigned, in a 1:1 ratio, women carrying singleton fetuses with severe isolated congenital diaphragmatic hernia on the left side to FETO at 27 to 29 weeks of gestation or expectant care. Both treatments were followed by standardized postnatal care. The primary outcome was infant survival to discharge from the neonatal intensive care unit. We used a group-sequential design with five prespecified interim analyses for superiority, with a maximum sample size of 116 women. RESULTS The trial was stopped early for efficacy after the third interim analysis. In an intention-to-treat analysis that included 80 women, 40% of infants (16 of 40) in the FETO group survived to discharge, as compared with 15% (6 of 40) in the expectant care group (relative risk, 2.67; 95% confidence interval [CI], 1.22 to 6.11; two-sided P = 0.009). Survival to 6 months of age was identical to the survival to discharge (relative risk, 2.67; 95% CI, 1.22 to 6.11). The incidence of preterm, prelabor rupture of membranes was higher among women in the FETO group than among those in the expectant care group (47% vs. 11%; relative risk, 4.51; 95% CI, 1.83 to 11.9), as was the incidence of preterm birth (75% vs. 29%; relative risk, 2.59; 95% CI, 1.59 to 4.52). One neonatal death occurred after emergency delivery for placental laceration from fetoscopic balloon removal, and one neonatal death occurred because of failed balloon removal. In an analysis that included 11 additional participants with data that were available after the trial was stopped, survival to discharge was 36% among infants in the FETO group and 14% among those in the expectant care group (relative risk, 2.65; 95% CI, 1.21 to 6.09). CONCLUSIONS In fetuses with isolated severe congenital diaphragmatic hernia on the left side, FETO performed at 27 to 29 weeks of gestation resulted in a significant benefit over expectant care with respect to survival to discharge, and this benefit was sustained to 6 months of age. FETO increased the risks of preterm, prelabor rupture of membranes and preterm birth. (Funded by the European Commission and others; TOTAL ClinicalTrials.gov number, NCT01240057.)

Targeted gene expression profiling for accurate endometrial receptivity testing

Abstract Expressional profiling of the endometrium enables the personalised timing of the window of implantation (WOI). This study presents and evaluates a novel analytical pipeline based on a TAC-seq (Targeted Allele Counting by sequencing) method for endometrial dating. The expressional profiles were clustered, and differential expression analysis was performed on the model development group, using 63 endometrial biopsies spanning over proliferative (PE, n = 18), early-secretory (ESE, n = 18), mid-secretory (MSE, n = 17) and late-secretory (LSE, n = 10) endometrial phases of the natural cycle. A quantitative predictor model was trained on the development group and validated on sequenced samples from healthy women, consisting of 52 paired samples taken from ESE and MSE phases and five LSE phase samples from 31 individuals. Finally, the developed test was applied to 44 MSE phase samples from a study group of patients diagnosed with recurrent implantation failure (RIF). In validation samples (n = 57), we detected displaced WOI in 1.8% of the samples from fertile women. In the RIF study group, we detected a significantly higher proportion of the samples with shifted WOI than in the validation set of samples from fertile women, 15.9% and 1.8% (p = 0.012), respectively. The developed model was evaluated with an average cross-validation accuracy of 98.8% and an accuracy of 98.2% in the validation group. The developed beREADY screening model enables sensitive and dynamic detection of selected transcriptome biomarkers, providing a quantitative and accurate prediction of endometrial receptivity status