The aim of this study was to explore the inter-relationship between polycystic ovary syndrome and gestational diabetes mellitus, and demonstrate maternal and fetal outcomes. This was a case-control study in 1360 pregnant women who received a diagnosis of gestational diabetes mellitus between 24 and 28 weeks of gestational age. Among all diagnosed with gestational diabetes mellitus, 150 pregnant women had received a polycystic ovary syndrome, and 160 women who did not have polycystic ovary syndrome were designated as controls. The incidence of pregnancy-induced hypertension was 26.3% and 12% in the case and control groups, respectively. Preeclampsia was seen at an incidence of 12% and 6% in case and in control groups, respectively. The difference in neonatal hypoglycemia between the two groups was statistically significant, with an incidence of 17% and 5% in the case and in control groups, respectively. This study demonstrated that the presence of polycystic ovary syndrome along with gestational diabetes mellitus increases the risk of pregnancy induced hypertension by 2.4 fold, preeclampsia by 2 fold and neonatal hypoglycemia by 3.2 fold, compared to gestational diabetes mellitus alone.

OBJECTIVEThis study aims to investigate predictive risk factors in the treatment of gestational diabetes mellitus (GDM).PATIENTS AND METHODSA total of 256 pregnant women who underwent 75 g oral glucose tolerance test (OGTT) during 24–28 weeks of pregnancy were included according to the World Health Organization criteria. Demographic characteristics of the patients, including age, parity, family history of diabetes, body weight before pregnancy, and body weight at the diagnosis of GDM, were recorded. Fasting insulin and hemoglobin A1c (HbA1c) values at the time of diagnosis were evaluated. The patients were divided into two groups: those requiring insulin treatment (insulin group, n = 89) and those receiving diet therapy (diet group, n = 167) during pregnancy according to the American Diabetes Association recommendations.RESULTSA total of 34.76% of the pregnant women with GDM required insulin treatment. The mean age of these patients was significantly higher compared to the diet group (34.9 ± 0.6 years vs. 31.9 ± 0.6 years; P = 0.004). Body mass index before pregnancy was also significantly higher in the insulin group than that in the diet group (32 ± 0.9 kg/m2 vs. 29 ± 0.7 kg/m2; P = 0.004). Fasting blood glucose (FBG) during OGTT was 105.6 ± 2.1 mg/dL and 96.7 ± 1.1 mg/dL in the insulin group and diet group, respectively (P < 0.001). There was no significant difference in fasting plasma glucose during OGTT between the groups (P = 0.069), while plasma glucose at two hours was 161.1 ± 6.8 mg/dL in the insulin group and 145.1 ± 3.7 mg/dL in the diet group (P = 0.027). At the time of diagnosis, HbA1c values were significantly higher in the insulin group compared to the diet group (5.3 ± 0.1 vs. 4.9 ± 0.1; P = 0.001). There was no significant difference in FBG and homeostasis model assessment-insulin resistance values between the groups (P = 0.908, P = 0.073).CONCLUSIONOur study results suggest that age, family history of diabetes, body weight before pregnancy, FBG, and HbA1c values are predictors for the necessity of insulin treatment.

Results: Approximately 28% of the pregnant women aged younger than 35 years with no risk factors for gestational diabetes mellitus were diagnosed with the oral glucose tolerance test in this study. In the gestational diabetes mellitus group, the primary cesarean section rate was importantly higher than that in the non-gestational diabetes mellitus group. Preterm delivery was also associated with gestational diabetes mellitus. The diagnosis of gestational diabetes mellitus was strongly associated with admittance to the neonatal intensive care unit. Neonatal respiratory problems didn't showed any significant deviation between the groups. There was a moderate association between gestational diabetes mellitus and metabolic complications. Conclusion:Pregnant women with no obvious risk factors were diagnosed with gestational diabetes mellitus using the World Health Organization criteria. The treatment of these women potentially reduced their risk of adverse maternal and neonatal hyperglycemia-related events, such as cesarean section, polyhydramnios, preterm delivery, admission to neonatal intensive care unit, large for gestational age, and higher neonatal weight. (J Turk Ger Gynecol Assoc 2015; 16: 25-9) Keywords: Gestation, diabetes mellitus, pregnancy, oral glucose tolerance test, neonatal outcomes Received: 25 July, 2014 Accepted: 10 January, 2015 Gestational diabetes mellitus screening and outcomesHale Lebriz Aktün, Derya Uyan, Betül Yorgunlar, Mustafa Acet Department of Obstetrics and Gynecology, İstanbul Medipol University Hospital, İstanbul, Turkey AbstractOriginal Investigation 25 treatment with self-observing of blood glucose levels (fasting and 1 h after each meal) daily with a glucometer. Subsequent follow-ups were conducted for all patients biweekly or more frequently as indicated. Treatment outcomes were evaluated according to the American Diabetes Association recommendations (6). All demographic characteristics (age, parity, family history of diabetes, and self-reported prepregnancy weight) of the patients were obtained from their existing records. Birth mode (cesarean or vaginal delivery) and labor induction, preterm delivery (delivery before 37 weeks of gestation), gestational hypertension, preeclampsia, polyhydramnios, and oligohydramnios were also documented from these records. The recorded adverse fetal outcomes were infant death, stillbirth, dystocia, bone fracture, nerve palsy, admission to the neonatal intensive care unit (NICU), respiratory complications [including respiratory distress syndrome (RDS) and transient tachypnea of newborn (TTN)] that increased birth weight, macrosomy (birth weight of >4000 g), large for gestational age (LGA, defined as birth weight> the 90 th percentile on standard charts), small for gestational age (SGA, defined as birth weight < the 10 th percentile on standard charts), and metabolic complications including hypocalcemia, hemoglobin level ≥20 g/dL, hypoglycemia (blood glucose level ≤35 mg/dL), and hyperbilirubinemia requiring phototherapy. ResultsThe pr...

BackgroundWe aimed to present the relationship between premature progesterone elevation (PPE) and clinical outcomes in high-responder patients who had a coasting period of <4 days in length due to their high risk of developing ovarian hyperstimulation syndrome (OHSS) and who were treated with a long-acting gonadotropin-releasing hormone agonist (GnRH-agonist) protocol in in vitro fertilization-embryo transfer (IVF-ET) cycles.Material/MethodsThis retrospective study was conducted at the University Hospital Assisted Reproductive Technology Center. The outcomes of 101 patients undergoing IVF- intracytoplasmic sperm injection (ICSI) cycles who showed a high response to COH (estradiol >4000 pg/ml and/or >20 follicles each ≥10 mm in diameter and at least 20% ≥15 mm) and who were coasted for <4 days were evaluated. Number of oocytes, 2 pronuclei (PN) embryos, implantation rate, and live birth rate were measured.ResultsThe incidence of PPE was 32.6%. Compared with those without PPE, patients with PPE had a higher number of oocytes retrieved. Total mature and fertilized oocytes and the mean number of embryos transferred were not significantly different between groups. Live birth rates (41.9% vs. 38.7%) and implantation rates (26.5% vs. 23%) were also not significantly divergent in the PPE and non-PPE groups, respectively.ConclusionsP concentrations ≥1.3 ng/ml on the day of human chorionic gonadotropin (hCG) administration, designated in this study as PPE, does not appear to be related to adverse effects in terms of clinical outcomes in high-responder patients undergoing coasting <4 days due to their high risk of developing OHSS treated with a long-acting GnRH-a protocol in IVF-embryo transfer cycles.

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