Background: An oral glucose tolerance test with a result that is negative but close to the diagnostic cut-off in early pregnancy was hypothesized to serve as a predictor of subsequent gestational diabetes in a high ri...Background: An oral glucose tolerance test with a result that is negative but close to the diagnostic cut-off in early pregnancy was hypothesized to serve as a predictor of subsequent gestational diabetes in a high risk group. The aim of the study was to determine those cut-off values of OGTT at gestational weeks ≤ 16, which can predict or exclude subsequent onset of GDM in a high risk group. Methods: Pregnant women at high risk of gestational diabetes (n = 163) underwent a 2-h, 75-g oral glucose tolerance test at gestational weeks ≤ 16 were analyzed in this study. In the event of a negative result, subsequent oral glucose tolerance tests were performed at gestational weeks 24-28 and 32-34. The sensitivity, the specificity, the positive and negative predictive values and the Odds ratio of the best cut-off values of fasting and postload glucose levels were calculated. Results: The best cut-off values to exclude subsequent GDM for fasting and postload glucose were 5.0 and 6.2 mmol/l, respectively. In combination, the best cut-off values were 5.3 mmol/l for fasting and 6.8 mmol/l for postload glucose, with negative predictive values of 0.97 and 0.71 and sensitivities of 96.9 and 86.3 at gestational weeks 24-28 and 32-34, respectively. Combination of these cut-off values with obesity proved to be very predictive for gestational diabetes by gestational weeks 32-34, with an Odds ratio of 6.0 95% confidence interval: 1.7-21.0 . Conclusions: With regard to the very high negative predictive value of the method, pregnant women with glucose levels of ≤ 5.3 mmol/l at fasting and of ≤ 6.8 mmol/l at postload in gestational weeks ≤ 16 should undergo subsequent oral glucose tolerance testing merely at gestational weeks 3234. Approximately a quarter (24.5% ) of the pregnant women at risk of gestational diabetes satisfied these criteria.展开更多
Objective: To assess the level of patient satisfaction after transcervical endometrial resection(TCRE) with no preoperative hormonal preparation. Study design: A retrospective audit of a continuous case series was acc...Objective: To assess the level of patient satisfaction after transcervical endometrial resection(TCRE) with no preoperative hormonal preparation. Study design: A retrospective audit of a continuous case series was accomplished on 131 consecutive patients who underwent TCRE for dysfunctional uterine bleeding. Data of postal questionnaires were analysed and subjected to survival analysis. Results: Thirty-three cases were lost to follow-up; thus, the data on 98 of the 131(74.8%)-patients were analysed. The average follow-up period was 94.8 months(60-132). Twenty(20.4%) women required D&C and 15(15.3%) had hysterectomy. In eight of the 15 cases, the indication for hysterectomy was not related with the primary operation. The chance of avoiding hysterectomy reached a plateau after 72 months, at 78.3%(SE: 5.05%). The chance of avoiding D&C at up to 36 months was 98.6%(SE: 1.4%), and reached a plateau after 107 months at 67.11%(SE: 6.1%)-; 55.8%of the patients became amenorrhoeic, the remaining cases reporting good improvements in the amount and duration of bleeding, and dysmenorrhoea. Eighty-six of the 98 patients(88%) were satisfied or very satisfied with the result. Conclusions: TCRE affords reasonable long-term effectiveness in the treatment of dysfunctional uterine bleeding, even without any preoperative hormonal endometrial preparation.展开更多
文摘Background: An oral glucose tolerance test with a result that is negative but close to the diagnostic cut-off in early pregnancy was hypothesized to serve as a predictor of subsequent gestational diabetes in a high risk group. The aim of the study was to determine those cut-off values of OGTT at gestational weeks ≤ 16, which can predict or exclude subsequent onset of GDM in a high risk group. Methods: Pregnant women at high risk of gestational diabetes (n = 163) underwent a 2-h, 75-g oral glucose tolerance test at gestational weeks ≤ 16 were analyzed in this study. In the event of a negative result, subsequent oral glucose tolerance tests were performed at gestational weeks 24-28 and 32-34. The sensitivity, the specificity, the positive and negative predictive values and the Odds ratio of the best cut-off values of fasting and postload glucose levels were calculated. Results: The best cut-off values to exclude subsequent GDM for fasting and postload glucose were 5.0 and 6.2 mmol/l, respectively. In combination, the best cut-off values were 5.3 mmol/l for fasting and 6.8 mmol/l for postload glucose, with negative predictive values of 0.97 and 0.71 and sensitivities of 96.9 and 86.3 at gestational weeks 24-28 and 32-34, respectively. Combination of these cut-off values with obesity proved to be very predictive for gestational diabetes by gestational weeks 32-34, with an Odds ratio of 6.0 95% confidence interval: 1.7-21.0 . Conclusions: With regard to the very high negative predictive value of the method, pregnant women with glucose levels of ≤ 5.3 mmol/l at fasting and of ≤ 6.8 mmol/l at postload in gestational weeks ≤ 16 should undergo subsequent oral glucose tolerance testing merely at gestational weeks 3234. Approximately a quarter (24.5% ) of the pregnant women at risk of gestational diabetes satisfied these criteria.
文摘Objective: To assess the level of patient satisfaction after transcervical endometrial resection(TCRE) with no preoperative hormonal preparation. Study design: A retrospective audit of a continuous case series was accomplished on 131 consecutive patients who underwent TCRE for dysfunctional uterine bleeding. Data of postal questionnaires were analysed and subjected to survival analysis. Results: Thirty-three cases were lost to follow-up; thus, the data on 98 of the 131(74.8%)-patients were analysed. The average follow-up period was 94.8 months(60-132). Twenty(20.4%) women required D&C and 15(15.3%) had hysterectomy. In eight of the 15 cases, the indication for hysterectomy was not related with the primary operation. The chance of avoiding hysterectomy reached a plateau after 72 months, at 78.3%(SE: 5.05%). The chance of avoiding D&C at up to 36 months was 98.6%(SE: 1.4%), and reached a plateau after 107 months at 67.11%(SE: 6.1%)-; 55.8%of the patients became amenorrhoeic, the remaining cases reporting good improvements in the amount and duration of bleeding, and dysmenorrhoea. Eighty-six of the 98 patients(88%) were satisfied or very satisfied with the result. Conclusions: TCRE affords reasonable long-term effectiveness in the treatment of dysfunctional uterine bleeding, even without any preoperative hormonal endometrial preparation.
