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H W Sutherland

Publications and source records attributed to H W Sutherland.

At least 37 records · Page 2Linked to original sources
PubMed1982

Fetal loss and maternal glucose intolerance. A retrospective study.

The premise that unexplained fetal loss is associated with maternal intravenous glucose intolerance (IVGT) has been studied retrospectively in three pregnancy related groups. In 97 women (Group A) who had stillbirths inadequately explained by obstetrical or necropsy findings, 24 per cent had abnormal IVGT tested six weeks postpartum. In 115 women (Group B) with histories of two or more spontaneous abortions (recurrent abortion) tested late in a subsequent successful pregnancy 26 per cent were abnormal. In 465 pregnancies of women with abnormal IVGT diagnosed during pregnancy (Group C) there were 19 perinatal deaths (12 stillbirths and 7 first week deaths) (Perinatal Mortality Rate 41 per 1000). Perinatal mortality characteristics which are similar to those found in insulin dependent diabetes namely a high incidence of major fetal abnormality (37 per cent) and the occurrence of hyaline membrane disease in term infants were observed. A causal association is postulated between inadequately explained stillbirth and recurrent abortion and abnormal maternal IVGT.

Abortion, Habitual↗
PubMed1981

Placental protein 5 (PP5) in complicated pregnancies.

Maternal serum PP5 concentrations were assayed in pregnancies complicated by intrauterine growth retardation, pre-eclampsia, diabetes mellitus, placental abruption and twins. Elevated PP5 levels were noted in twin pregnancies and to a lesser extent in diabetes and pre-eclampsia. Measurement of PP5 was of no value in the detection of fetal growth retardation. The great majority of PP5 levels above the normal range were associated with a placental abnormality.

Abruptio Placentae↗
PubMed1980

The insulin response to glucose infusion in gestational diabetes.

Using a glucose infusion test insulin responses and insulin sensitivities were studied in 15 gestational diabetic women at 36-40 weeks gestation. In all women intravenous glucose tolerance had returned to normal at six weeks postpartum. Twelve women had a repeat glucose infusion test done 7-24 weeks (mean 17 weeks) postpartum. The results were compared with previously evaluated normal non-pregnant and normal pregnant standards and insulin responses below the normal 15th percentile were defined as "low". Twelve women had "low insulin responses in late pregnancy, and six had "low" insulin responses postpartum. The mean insulin sensitivity index of 1.34 +/- 1.21 (mean +/- SD) was significantly higher in the gestational diabetic group during pregnancy compared with a control pregnant group at 0.53 +/- 0.21 (p less than 0.01). The findings in this study support the hypothesis that gestational diabetes may arise in women who are unable to achieve adequate insulinogenic compensation to pregnancy. Increased insulin sensitivity in gestational diabetes may be a compensatory mechanism.

Adult↗
PubMed1980

The insulin response to glucose infusion in normal human pregnancy.

To study insulin response and insulin sensitivity a glucose infusion test was devised. Twenty normal non-pregnant and twenty normal pregnant women had an intravenous glucose tolerance test followed by a glucose infusion test. In a normal pregnant group at 38-40 weeks gestation (n = 20) the plasma insulin response was found to be 3.7 times greater than that observed in a normal non-pregnant group (n = 20), while in the normal pregnant group the insulin sensitivity index was only 18 per cent of that observed in the non-pregnant group. Intravenous glucose tolerance in the non-pregnant women was observed to correlate with the insulin sensitivity index (r = 0.61, p less than 0.05) but in the pregnant women it correlated with the insulin response (r = 0.66, p less than 0.01). These findings support the hypothesis that in the non-pregnant state intravenous glucose tolerance may be primarily related to insulin sensitivity while during pregnancy it may be related to the degree of compensatory hyperinsulinism.

Adult↗
PubMed1980

Glucose tolerance in the heavy-for-date neonate: a pilot study.

Intravenous glucose tolerance tests were performed on 12 infants with birth-weights above the 95th centile (corrected for maternal height, weight and social class and for the gestation, sex and birth rank of the infant). In 4 infants the glucose disappearance rate (kt) was abnormally high (> 2.05), but glucose tolerance and birth weight were not correlated. However, enhanced glucose tolerance was significantly and positively correlated with obesity in the infant. Although these infants are biochemically abnormal, there is no evidence that this abnormality constitutes a clinical hazard.

Birth Weight↗
PubMed1977

Maternal plasma glucose and free fatty acid concentrations related to infant birth weight.

A new and specific method is used for the measurement of plasma free fatty acids (FFA) in pregnancy. Fasting plasma FFA and glucose concentrations were measured serially in twenty normal and twelve overweight women in pregnancy and related to infant birth weight. Large variation between individuals was noted for FFA and no change was found with advancing gestation. Studies of the day-to-day variation in the same women at 20 and 36 weeks gestation showed wide variations in concentrations. No significant change in glucose concentration was noted with advancing gestation, but postnatal values were significantly higher. Small variability of glucose concentrations was noted in both the serial and day-to-day studies. In normal-weight women a positive correlation between the observed birth weight of their infants and the fasting plasma glucose levels was found at 20 and 40 weeks and also with the mean of 5 levels measured in pregnancy. No similar correlation was found for the group of overweight women.

Adolescent↗
PubMed1975

Palmitic acid concentrations and lecithin/sphingomyelin ratios in amniotic fluid.

Palmitic acid concentrations and L/S ratios have been estimated in amniotic fluid specimens with and without centrifugation and cold acetone precipitation. Although the number of cases was small, both of these measurements in uncentrifuged fluid seemed to reflect only indirectly on lung maturation in normal pregnancy while with centrifuged fluid the L/S value predicted RDS in one infant more reliably than palmitic acid concentration.

Acetone↗
PubMed1973

Evaluation of chlorpropamide in chemical diabetes diagnosed during pregnancy.

The intravenous glucose tolerance test (I.V.G.T.T.) was used to diagnose chemical diabetes during pregnancy in 180 women, 50 of whom subsequently received chlorpropamide therapy in a daily dosage of 100 mg; the remainder had no drug therapy.Preliminary work showed the I.V.G.T.T. to be reproducible in the second and third trimesters but not in the puerperium in normal pregnancy. Though intravenous glucose tolerance deteriorates between the second and third trimesters in women with no features of diabetes, a significant improvement occurs after a course of chlorpropamide in a daily dosage of 100 mg during pregnancy in chemical diabetes, but this treatment did not enhance the rate of return to normal glucose tolerance post partum.Plasma glucose and insulin studies showed no evidence of hypoglycaemia or hyperinsulinism in the mother at delivery or in the newborn when chlorpropamide had been used compared with a group receiving no such treatment. In the infants of the chlorpropamide-treated mothers there was a suggestion of an increased rate of glucose disposal in response to a glucose challenge, but no increase in birth weight.There were two fetal deaths in the 50 pregnancies of mothers treated with chlorpropamide, one being due to a mistaken premature delivery and the other to a diaphragmatic hernia. Thus chlorpropamide in a dose of 100 mg a day has been shown to reverse chemical diabetes diagnosed and treated in pregnancy without apparent risk to the fetus.

Birth Weight↗