الفهرس 
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Abstract
The aim of this work is to evaluate maternal hypoglycaemia
as a causative factor of IUGR and the value of intravenous glucose
tolerance test as a method of prediction of IUGR.
One hundred two cases in the third trimester of pregnancy attending
Kafr EI Shikh general hospital antenatal clinic were studied. Patients
choosen for the study had a high risk of developing IUGR. Cases included
in the study: 71 patients had a single risk factors for lUGR including:
Preeclampsia (50 cases), Eclampsia (6),anaemia (9) and Cardiac disease (6).
2) 31patients had multiple risk factor for IUGR including.
Preeclampsia + anaemia (17), preeclampsia + cardiac d. (5). Preeclampsia+
anaemia + cardiac disease (one case), Eclampsia + anaemia (5) and
cardiac disease + anaemia (3 cases).:
IV.GTT was performed.
Fasting blood sugar and 10 minutes and 60 minutes blood glucose
after IV. glucose injection was analized by using glucometer apperatus.
Newly born infants’ weight was recorded and IUGR could be diagnosed
(birth weight below the 10 percentile according to gestational age.
assessment of anatomical features that indicates maturity in the
newly born was also performed.
IUGR babies were compared to hypoglycaemia and statistical evaluation
of the significance of hypoglycaemia as a cause of lUGR was
studied in all cases.
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There was a significant correlation between maternal hypoglycaemia
and lUGR in the studied group. Also there was a tendency towards
lowering blood sugar level I in growth retarded newly born infants.
Fasting blood sugar level and at 10 minutes and 60 minutes after
IV. glucose load were silgnificantly lower in cases with IUGR than
in cases with no IUGR.
In patients with a single risk factor for IUGR there was no statistically
significant difference between the number of lUGR in those with
hypoglycaemic compared to those with normoglycaemic mothers
(P> 0.05).
In patients with multiple risk factors for IUGR, the number of IUGR
infants was statistically higher in hypoglycaemic patients .(P < 0.0001)
In patients with pregnancy toxaemia only; there was no statistical
difference between the number of IU.GR infants in hypoglycaemic
IX normoglycaemic groups P <. 0.05. So hypoglycaemia was not a
factor associated with the occurrane of IUGR in patients with pregnancy
toxaemia only.
In patients with pregnancy toxaemia associated with other risk factor
the number of IUGR infants was statistically more in hypoglycaemia
compared to normoglycaemic groups therefore hypoglycaemia was
a factor associated with the occurrance of IUGR.
Anaemia appears to represent a significant cause in IUGR only if
associated with other maternal diseases such as pregnancy toxaemia
and cardiac disease.
In cardiac patients the number of IUGR was statistically more in
the hypoglycaemia group (P = 0.01), most probably due to association
with other maternal diseases.
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CONCLUSIONS
We agree with most workers that hypoglycaemia may be
a causative factor in lUGR in patients with a high risk prelgnancy
and IV.GTT is a good tool in predecting IUGR in these patients.
Fasting blood glucose is a good negative test as it had a
false -ve result around 15%. However, if it is -ve (less than 60 rng/dl),
it has a galse -ve result of 37%. Therefore, it needs to be bached
by the 10 minutes blood glucose level which had a false -ve result
around 14% and so it increases the accurracy of fasting blood glucose
test by 23%.