Cases reported "Pregnancy in Diabetics"

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1/6. Neonatal small left colon syndrome: intramural not intraluminal obstruction.

    We have described a characteristic syndrome of intestinal dysfunction in infants of diabetic mothers. This finding appears to result from a transient intramural dysfunction. Many respond to rectal irrigations alone. However, a significant number will require close observation and possible diversion for persistent partial intestinal obstruction. Failure to recognize persistent obstruction may result in intestinal perforation.
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2/6. Neonatal small left colon syndrome. Occurrence in asymptomatic infants of diabetic mothers.

    An unusually high incidence (40%) of maternal diabetes was observed in a series of 20 newborn infants who had low colonic obstruction and barium enema findings of a uniformly narrowed colon from the splenic flexure to the anus. This has been termed the "neonatal small left colon syndrome." We investigated the incidence of this colon configuration in gastrointestinally asymptomatic infants of diabetic mothers. Of 12 such infants examined by barium enema, six have shown this same narrowing of the left colon. The relationship of maternal diabetes to the small left colon is not yet clearly understood.
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3/6. Unilateral renal agenesis associated with urinary outflow tract obstruction in a diabetic pregnancy.

    We report a case of diabetic pregnancy where the foetus had enlarged cystic left kidney with agenesis of right kidney. The urinary bladder was dilated and urethra revealed posterior urethral valve an postmortem.
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4/6. Severe obstructive sleep apnea and associated snoring documented during external tocography.

    Severe obstructive sleep apnea, a disturbance of sleep resulting from intermittent periodic obstruction of the upper airway, was diagnosed after cardiotocography during which the external tocodynamometer disclosed a pattern initially thought to represent uterine activity. In spite of this obstructive sleep apnea with associated markedly low, hypoxic oxygen saturation levels and daytime somnolence of 10 to 12 hours from 32 weeks until delivery, subsequent fetal outcome was good.
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5/6. Neonatal small left colon syndrome.

    Neonatal small left colon syndrome is a functional disease of the lower colon which produces typical signs and symptoms of intestinal obstruction. It is manifest in the first 24-48 hours of life, particularly in infants of diabetic mothers and, if detected early, it can be fully cured by radiographic contrast enemas, not unlike meconium plug syndrome. intestinal perforation and death may occur, however. The etiology of the disease is unknown but it may relate to neurohumoral imbalances between the autonomic nervous system and glucagon.
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6/6. Difficulties in "real-time" ultrasound diagnosis of fetal urological anomalies.

    In the fetus of a diabetic woman, at the 24th week of pregnancy urological anomalies (cystic kidney malformations) were found with real-time ultrasound. At the 34th week these findings were confirmed and interpreted to be due to a lower urinary obstruction. Therefore a preterm Caesarean section was performed. In the newborn the left multicystic kidney was removed. The indications for the US screening in pregnancy and difficulties in the interpretation of urological findings of fetal and newborn ultrasonograms are discussed.
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