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Biomedical subjects

J van Roosmalen

Publications and source records attributed to J van Roosmalen.

79 records · Page 5Linked to original sources
PubMed1988

Multiple pregnancy as a risk factor in rural Tanzania.

The prevalence of twin pregnancies in two rural hospitals in the South Western Highlands of Tanzania ranged from 15 to 20 per 1,000 births. The literature on the generally assumed high twinning rates in the whole of Africa is reviewed. High prevalence figures can be the result of hospital selection, as most African studies are hospital-based. Only from Nigeria, one population-based study revealed a rate of 45 per 1,000. In both hospitals perinatal mortality in twin births was strikingly low, especially when birthweight was at least 1,500 g: between 30 and 40 per 1,000 births. It is argued that there is no place for a more liberal use of caesarean section to further reduce perinatal mortality.

Birth Weight↗
PubMed1987

Symphysiotomy as an alternative to cesarean section.

The author compares the value of symphysiotomy to cesarean section in the management of cephalopelvic disproportion. He outlines the history of the procedure and reviews the literature on the subject. He then presents results of 54 symphysiotomies performed from 1976 to 1983 in two rural hospitals in the southwestern highlands of Tanzania, together with the outcome of subsequent labor in 25 other women with a history of previous symphysiotomy. The risk of maternal mortality after symphysiotomy is lower than after cesarean section when performed for cephalopelvic disproportion. Although different in nature, maternal morbidity after both operations is equally common. In contrast with findings reported in the literature, a history of previous symphysiotomy still constitutes a high obstetrical risk. The author concludes that symphysiotomy has a place in the management of cephalopelvic disproportion.

Africa↗
PubMedDate not supplied

HbA1c in healthy, pregnant women.

AIM: Congenital malformations and macrosomia in infants of women with type 1 diabetes mellitus (DM1) still occur, even if diabetic control is considered 'good' (i.e. HbA1c below the nonpregnant upper reference value of 6.3%). We, therefore, measured HbA1c in healthy, pregnant women to determine whether the upper reference value for pregnant women should be lower than the nonpregnant value. METHODS: We investigated HbA1c, measured by high-performance liquid chromatography (HPLC), in two groups of healthy primigravid women. Group 1 (n=30; 30.0 +/- 5.3 (mean +/- sd) years; body mass index (BMI) before pregnancy 21.7 +/- 5.3 kg/m2) had a gestational age of 30 weeks (34.6 +/- 2.5) pregnant. None of the women had diabetes in the family in the first and/or second degree. RESULTS: Group 1 had an HbA1c of 4.3 +/- 0.3% (range 3.9-5.0) and in group 2 the HbA1c was 4.7 +/- 0.4% (range 3.6-5.9) (p < 0.001). No relation was found between HbA1C and BMI vs birth weight, corrected for gestational age, within the groups. CONCLUSIONS: Healthy, pregnant women had a low HbA1C, particularly in the first trimester of pregnancy. This might implicate that for prevention of congenital malformations and macrosomia in pregnant DM1 women and HbA1C should be below 5% in the first trimester of pregnancy and below 6% in the third trimester.

Adult↗