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Biomedical subjects

S G Gabbe

Publications and source records attributed to S G Gabbe.

At least 109 records · Page 6Linked to original sources
PubMed1984

Human fetal weight and placental weight growth curves. A mathematical analysis from a population at sea level.

A mathematical analysis of human fetal and placental growth curves was made on data collected prospectively from a population at sea level. Both the fetal and placental growth curves can best be described by a form of the logistic equation inhibited growth model. The fetal growth rate reaches its maximum approximately 4 weeks after the placental growth rate has reached its maximum. Growth rate constants were calculated for several populations at various altitudes.

Altitude↗
PubMed1984

Decision analysis of high-risk patient referral.

Decisions to refer obstetric patients are often complicated by social and financial considerations as well as medical risks. To study such decisions, 600 Fellows of the American College of Obstetricians and Gynecologists were studied using a new decision analysis technique. It was found that obstetricians base their referrals predominantly on medical factors, but that other considerations can affect a close decision. Physicians differed on their indications to refer, as well as on the weight placed on some factors. Such differences could not be explained by age, training, or practice characteristics. Studying the referral process is important because successful regionalization depends on appropriate referral.

Analysis of Variance↗
PubMed1983

(3-sn-Phosphatidyl)cholines (lecithins) in amniotic fluid.

Many currently used thin-layer chromatographic methods for phospholipid assay rely on charring the developed plate in the presence of cupric acetate. Saturated acyl phospholipids do not react. We find that substitution of cupric sulfate results in detection of both saturated and unsaturated phospholipids. By exploiting the difference with the two reagents, one can separately estimate the amounts of saturated phospholipid. The method described here is reproducible, and we illustrate its use in determinations of (3-sn-phosphatidyl)cholines (lecithins) in amniotic fluid from problem pregnancies.

Amniotic Fluid↗
PubMed1982

Comparison of glycohemoglobin determination and the one-hour oral glucose screen in the identification of gestational diabetes.

A prospective study was undertaken to evaluate the use of glycohemoglobin (HbA1) as a screening tool for the detection of gestational diabetes in 90 subjects. At 28 to 30 weeks, these patients had an HbA, determination prior to diabetes screening with a 1-hour serum glucose after 50 gm of oral glucose. Those women with an abnormal screening result were then evaluated with a standard 3-hour oral glucose tolerance test. Forty-seven women had an abnormal 1-hour serum glucose (greater than or equal to 140 mg/dl). Nine of these 47 women (19%) had an abnormal HbA1. Four of these nine women (44.4%) with an abnormal screening glucose as well as an abnormal HbA1 demonstrated an abnormal oral glucose tolerance test. Eleven of 38 women (29%) with an abnormal glucose screen but normal HbA1 had an abnormal glucose tolerance test. The combination of two abnormal tests, glucose screen and HbA1, predicted gestational diabetes in only four of 15 (27%) of our patients. The sensitivity and specificity of this combination were 22.4% and 87.8%, respectively. The median values of HbA, with normal and abnormal glucose tolerance tests were 7.8% (range, 4.9% to 11.5%) and 8.2% (range, 5.4% to 12%), respectively. These values were not significantly different. These data confirm that HbA, alone or in combination with a 50 gm glucose screen is not a sensitive screening tool for the detection of gestational diabetes mellitus.

Diabetes Mellitus↗
PubMed1982

Effect of dietary fiber on the oral glucose tolerance test in pregnancy.

Paired oral glucose tolerance tests (GTTs) were performed during the third trimester of pregnancy to determine whether soluble fiber, which is known to blunt the rise in postprandial serum glucose in nonpregnant subjects, demonstrated similar effects in pregnancy. Normal pregnant women (n = 14) and gestational diabetic patients (n = 4) were first given a standard 100 gm oral GTT, and serum levels of glucose and insulin were determined in the fasting state and at 60, 120, and 180 minutes after ingestion of the glucose load. Several days later, a second GTT was done. In this test, glucose was combined with 15 gm guar gum, a purified soluble dietary fiber. Improved glucose tolerance was documented in all but one patient. Guar gum produced a significant reduction in mean serum glucose levels at 1 hour (p less than 0.005), 2 hours (p less than 0.005), and 3 hours (p less than 0.005), and each of the four gestational diabetic patients tested showed a normal glucose tolerance curve. The soluble dietary fiber, guar gum, did limit the postchallenge rise in serum glucose in pregnant subjects. Furthermore, the improvement in glucose tolerance in gestational diabetic patients is sufficient to suggest a potential clinical value for dietary fiber in the treatment of gestational diabetes.

Dietary Fiber↗
PubMed1982

Fetal and neonatal hazards of maternal hydration with 5% dextrose before caesarean section.

In a prospective randomised study, 47 fasting women undergoing elective caesarean section received one of the following three glucose regimens for prevention of hypotension before administration of epidural bupivacaine to produce anaesthesia from the T4 sensory level: (i) 150 ml of 5% dextrose in water (D5W) and 1000 ml normal saline (7.5 g dextrose); (ii) 150 ml of D5W, 350 ml of 5% dextrose in normal saline (D5NS), and 650 ml of normal saline (25 g dextrose); (iii) 150 ml D5W and 1000 ml D5NS (57.5 g dextrose). The maternal blood sugar at delivery was significantly raised in patients receiving 25 and 57.5 g of dextrose. 57.5 g of dextrose also raised the mean umbilical cord venous levels of glucose to 11.7 mmol/l and of insulin to 70 +/- 7 microU/ml, while decreasing glucagon to 24 +/- 5.3 pg/ml and arterial pH to 7.19 +/- 0.015 compared with the levels with 7.5 g dextrose. The raised insulin level caused neonatal hypoglycaemia (1.8 +/- 0.22 mmol/l) and delayed release of glucagon at 2 hours of age. There was a higher incidence of neonatal jaundice in infants exposed to 57.5 g of dextrose than in those exposed to 7.5 g. The addition of large amounts of dextrose to intravenous fluids was harmful to the fetus and of no benefit to the mother. Until a safe rate of administration is established, it is recommended that dextrose infusions immediately before delivery be limited to no more than 6 g/h.

Anesthesia, Conduction↗
PubMed1982

Glycemic control in pregnant diabetic women using a continuous subcutaneous insulin infusion pump.

Five insulin-dependent diabetics in the third trimester of pregnancy were first stabilized on morning and evening injections of both short- and long-acting insulin. Blood sugars were determined hourly from 7 A.M. to 7 P.M. and then every two hours from 7 P.M. to 7 A.M. After glycemic control was established, the patients were treated with continuous subcutaneous insulin infusion via a pump that administers a basal dosage at predetermined intervals and bolus doses preprandially. Mean blood sugar, glycemic excursions and intervals of hypoglycemia and hyperglycemia were calculated after three to five days of infusion therapy. The continuous subcutaneous insulin infusion with the pump did not improve glycemic control in the group as a whole, but in two of five patients there was a significant decrease in mean blood sugar. A trend towards a decrease in glycemic excursions as well as hypoglycemia and hyperglycemia was also obtained. Three patients were managed with long-term home and in-hospital use of the continuous subcutaneous insulin infusion pump. It proved to be efficacious and safe in establishing euglycemia. This study of a portable insulin infusion pump affirms its ability to maintain glycemic control and its safety for long-term therapy during pregnancy.

Diabetes Mellitus↗
PubMed1981

Amniotic fluid prolactin levels and lecithin/sphingomyelin ratios during the third trimester of human gestation.

Prolactin levels in amniotic fluid during the third trimester of human pregnancy showed a wide range of values. There was no apparent correlation between amniotic fluid prolactin concentrations (AF PRL) and lecithin/sphingomyelin (L/S) ratios nor was there a prolactin concentration associated with a mature L/S ratio. There was no correlation between AF PRL concentration and estimated gestational age or neonatal birth weight. In patients with diabetes mellitus (White Classes A to C), AF PRL were higher prior to 37 weeks, or when the L/S ratio was less than 2, than after 37 weeks, or when the L/S ratio was greater than 2.

Amniotic Fluid↗
PubMed1981

Diabetes mellitus in pregnancy: have all the problems been solved?

The past decade has seen a remarkable improvement in the prognosis for the pregnancy complicated by diabetes mellitus. Perinatal survival has become as common in these pregnancies as in normal ones. This improved outcome has been achieved through a better understanding of maternal metabolism and the needs to regulate maternal glycemia carefully as well as through reliable techniques for the surveillance of fetal well-being and advances in neonatal care. Significant perinatal morbidity still occurs, and congenital malformations--the leading cause of perinatal mortality today--remain an unresolved problem. Maternal outcome must also be considered. Uncertainty remains regarding the course of retinopathy in pregnancy, and the small group of diabetic women with coronary artery disease do appear to be at increased risk for mortality during gestation. A systematic screening program for gestational diabetes must now be adopted.

Carbohydrate Metabolism↗