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  1. Tan PC, Chai JN, Ling LP, Omar SZ
    Clin Exp Obstet Gynecol, 2011;38(2):150-4.
    PMID: 21793277
    OBJECTIVE: To evaluate maternal hemoglobin levels and red cell indices as predictive factors for gestational diabetes (GDM).

    METHOD: Data from 1,538 women were analyzed. At the first visit for prenatal care, the 50-gram glucose challenge test was followed by the 75-gram glucose tolerance test in those who screened positive. GDM was diagnosed based on the WHO (1999) criteria. Maternal complete blood count was obtained at the first visit, hospitalization for birth, and after birth. Receiver operator characteristic curves were generated to establish thresholds. Multivariable logistic regression analyses were performed to establish independent predictors of GDM.

    RESULTS: GDM was diagnosed in 182/1,538 (11.8%). GDM was associated with hemoglobin level, hematocrit and erythrocyte count at the first visit for prenatal care only. Hemoglobin threshold at the first visit was established at 11.5 g/dl. After adjustment, high hemoglobin [AOR 1.5 (95% CI 1.0-2.1); p = 0.027] remained predictive of GDM.

    CONCLUSIONS: High maternal hemoglobin level at the first prenatal visit is independently predictive of GDM.

  2. Tan PC, Vallikkannu N, Suguna S, Quek KF, Hassan J
    Clin Exp Obstet Gynecol, 2009;36(1):35-9.
    PMID: 19400416
    OBJECTIVE: To evaluate the predictive value for successful labor induction of transvaginal ultrasound (TVS) of cervical length according to parity.

    METHOD: TVS of the cervix was performed before term labor induction. Induction was considered successful if vaginal delivery was achieved within 24 hours; 231 women were available for final analysis.

    RESULTS: Analysis of the receiver operator characteristics curve showed an optimal cut-off for cervical length of < or = 20 mm for successful induction. Following multivariate logistic regression analysis, a sonographic short cervix (AOR 5.6; p < 0.001) was an independent predictor of successful induction but not a favorable Bishop score (p = 0.47). Among multiparas with a short cervix, positive and negative predictive values for successful induction were 98% (95% CI 90-100%) and 21% (95% CI 13%-32%) and among nulliparas, predictive values were 69% (95% CI 53%-82%) and 77% (95% CI 64%-87%) respectively.

    CONCLUSION: In nulliparas, cervical length can usefully predict labor induction outcome.

  3. Begum KS, Sachchithanantham K, De Somsubhra S
    Clin Exp Obstet Gynecol, 2011;38(1):14-20.
    PMID: 21485717
    The increasing prevalence of maternal obesity worldwide provides a major challenge to obstetric practice from preconception to postpartum. Maternal obesity can result in unfavorable outcomes for the woman and fetus. Maternal risks during pregnancy include gestational diabetes and chronic hypertension leading to preeclampsia. The fetus is at risk for stillbirth and congenital anomalies. Intrapartum care, normal and operative deliveries, anesthetic and operative interventions in the obese demand extra care. Obesity in pregnancy can also affect health later in life for both mother and child. For women, these risks include heart disease and hypertension. Children have a risk of future obesity and heart disease. Women and their offspring are at increased risk for diabetes. Obstetrician-gynecologists should be well informed to prevent and treat this epidemic. Interventions directed at weight loss and prevention of excessive weight gain during pregnancy must begin in the preconception period.
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