FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2065573046> ?p ?o ?g. }

• W2065573046 endingPage "536" @default.
• W2065573046 startingPage "513" @default.
• W2065573046 abstract "Despite the well-documented relationship between morbidity in pregnancy and pregestational maternal diabetes, the corrected perinatal outcome is, in most series, equal to or better than that of the general reference obstetric population. No single aspect or element of contemporary management is responsible for this improvement; rather, a combination of interventions seems responsible. Targeting delivery early in term, improved compliance, better glycemic control during pregnancy, improved control at conception, improved neonatal care, family planning, and early screening for fetal abnormalities all likely contribute to improved outcome. The currently observed rates of perinatal mortality suggest that an irreducible minimum mortality rate may be reached; however, large disparities in access to care and treatment continue to result in a wide range in rates of morbidity and mortality, a fact that pertains to outcomes in general as well as to pregnancies complicated by diabetes. The identification of women with lesser degrees of hyperglycemia as diabetic by lowering the thresholds for glucose tolerance test abnormality suggests an importance of the diagnosis that is not supported by evidence of either related morbidity or therapeutic benefit. The extrapolation of risk to women with lesser degrees of hyperglycemia seems to have little basis, and the management of women with mild glucose intolerance as if they had overt diabetes is unwarranted. The excess of resources dedicated to the identification and monitoring of an increasing number of women with mild abnormalities of glucose metabolism should prompt a reevaluation of these practices. Perinatal benefits of this expenditure are difficult to document or nonexistent, and there is a predictable increase in iatrogenic morbidities associated with the diagnosis. The exception in the most recent recommendations is the addition of a random glucose measure to screen for the rare women with overt undiagnosed diabetes who presents for prenatal care, because these women are at increased risk of morbidities related to diabetes. A curious statement was made in the summary and recommendations of the fourth International Congress on Gestational Diabetes: There remains a compelling need to develop diagnostic criteria for GDM [gestational diabetes mellitus] that are based on the specific relationships between hyperglycemia and risk of adverse outcome. If these relationships are undefined, what is the import of the diagnosis? At the author's center, application of the new diagnostic thresholds for the diagnosis of gestational diabetes mellitus has increased the incidence to over 6%. Without a clear expectation of benefit, this increase represents an unsupportable investment of resources. What are the prospects for improving understanding of the relationships between glucose intolerance and pregnancy risks? The direction of new guidelines and recommendations seems to be moving away from resolution of the relationships. The new criteria result in the diagnosis of gestational diabetes in an increasing number of women who were previously normal. It is easier to differentiate women at an extreme of hyperglycemia from normal. Investigations will be even less able to identify attributable effects of glucose intolerance in pregnancy with the inclusion of women with lesser degrees of hyperglycemia. As evidenced in O'Sullivan's original series, women with fasting hyperglycemia in pregnancy are still presumed to be at increased risk of fetal death. This risk factor remains important in clinical management if insulin treatment, fetal surveillance, and early term delivery can reduce the risk of fetal loss. At the author's center, the relationships among outpatient measures of fasting glycemia, glucose tolerance testing results, and perinatal outcomes are evaluated. Preliminary results suggest that fasting glycemia measured at the time of a 50-g glucose tolerance test is significantly correlated with and as sensitive and predictive of morbidity as the glucose tolerance test diagnosis of gestational diabetes. If these results are confirmed, it will be difficult to rationalize continued glucose tolerance testing." @default.
• W2065573046 created "2016-06-24" @default.
• W2065573046 creator A5088606038 @default.
• W2065573046 date "2001-09-01" @default.
• W2065573046 modified "2023-10-14" @default.
• W2065573046 title "DIABETES COMPLICATING PREGNANCY" @default.
• W2065573046 cites W1594937458 @default.
• W2065573046 cites W1608151369 @default.
• W2065573046 cites W1965900336 @default.
• W2065573046 cites W1969457947 @default.
• W2065573046 cites W1972339254 @default.
• W2065573046 cites W1973530424 @default.
• W2065573046 cites W1975261998 @default.
• W2065573046 cites W1978372459 @default.
• W2065573046 cites W1978572577 @default.
• W2065573046 cites W1982791066 @default.
• W2065573046 cites W1983471208 @default.
• W2065573046 cites W1990277221 @default.
• W2065573046 cites W1990626565 @default.
• W2065573046 cites W1994658985 @default.
• W2065573046 cites W2001576060 @default.
• W2065573046 cites W2006110486 @default.
• W2065573046 cites W2007477570 @default.
• W2065573046 cites W2011051602 @default.
• W2065573046 cites W2013924433 @default.
• W2065573046 cites W2020991820 @default.
• W2065573046 cites W2024245092 @default.
• W2065573046 cites W2024393497 @default.
• W2065573046 cites W2025623188 @default.
• W2065573046 cites W2027095279 @default.
• W2065573046 cites W2030247999 @default.
• W2065573046 cites W2033138196 @default.
• W2065573046 cites W2034922910 @default.
• W2065573046 cites W2037595728 @default.
• W2065573046 cites W2038686627 @default.
• W2065573046 cites W2045478413 @default.
• W2065573046 cites W2045958898 @default.
• W2065573046 cites W2050386427 @default.
• W2065573046 cites W2054207837 @default.
• W2065573046 cites W2055605011 @default.
• W2065573046 cites W2058804921 @default.
• W2065573046 cites W2058871230 @default.
• W2065573046 cites W2060627716 @default.
• W2065573046 cites W2061247277 @default.
• W2065573046 cites W2063726391 @default.
• W2065573046 cites W2063990215 @default.
• W2065573046 cites W2065150378 @default.
• W2065573046 cites W2067023215 @default.
• W2065573046 cites W2068205190 @default.
• W2065573046 cites W2072878267 @default.
• W2065573046 cites W2081466578 @default.
• W2065573046 cites W2086884666 @default.
• W2065573046 cites W2087398692 @default.
• W2065573046 cites W2090832862 @default.
• W2065573046 cites W2098760532 @default.
• W2065573046 cites W2118292348 @default.
• W2065573046 cites W2121257017 @default.
• W2065573046 cites W2121726535 @default.
• W2065573046 cites W2124392178 @default.
• W2065573046 cites W2127426945 @default.
• W2065573046 cites W2129821035 @default.
• W2065573046 cites W2140937253 @default.
• W2065573046 cites W2147881135 @default.
• W2065573046 cites W2152365967 @default.
• W2065573046 cites W2315491743 @default.
• W2065573046 cites W2326851691 @default.
• W2065573046 cites W2410125730 @default.
• W2065573046 cites W4229829688 @default.
• W2065573046 cites W4230968745 @default.
• W2065573046 cites W4231904020 @default.
• W2065573046 cites W4232058775 @default.
• W2065573046 cites W4232841444 @default.
• W2065573046 cites W4237969115 @default.
• W2065573046 cites W4240659264 @default.
• W2065573046 cites W4243841175 @default.
• W2065573046 cites W4243917891 @default.
• W2065573046 cites W4252494066 @default.
• W2065573046 cites W4298096442 @default.
• W2065573046 cites W65160267 @default.
• W2065573046 doi "https://doi.org/10.1016/s0889-8545(05)70215-1" @default.
• W2065573046 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/11512498" @default.
• W2065573046 hasPublicationYear "2001" @default.
• W2065573046 type Work @default.
• W2065573046 sameAs 2065573046 @default.
• W2065573046 citedByCount "59" @default.
• W2065573046 countsByYear W20655730462012 @default.
• W2065573046 countsByYear W20655730462013 @default.
• W2065573046 countsByYear W20655730462014 @default.
• W2065573046 countsByYear W20655730462015 @default.
• W2065573046 countsByYear W20655730462016 @default.
• W2065573046 countsByYear W20655730462017 @default.
• W2065573046 countsByYear W20655730462018 @default.
• W2065573046 countsByYear W20655730462019 @default.
• W2065573046 countsByYear W20655730462020 @default.
• W2065573046 countsByYear W20655730462021 @default.
• W2065573046 countsByYear W20655730462022 @default.
• W2065573046 countsByYear W20655730462023 @default.
• W2065573046 crossrefType "journal-article" @default.

• next