392 SPO Abstracts

5280 Magnetic-Resonance In Eclampsia: Clinical Correlation

529

LUIS Sanchez-Ramos MP, Timothy G Sanders MDx David A Clayman MDx, Frederick S Vines MDx, Departments of Obstetrics and Gynecology and Radiology, University of Florida Health Science Center/Jacksonville, Florida

PURPOSE: To determine the typical magnetic resonance imaging (MRI) lesions of the brain in patients with eclampsia and to correlate the neurologic exams with MRI abnormalities, MATERIALS AND METHODS: Cranial MRI studies were performed on 10 patients with eclampsia. Follow-up MRI studies were subsequently performed on all patients, RESULTS: All ten patients presented with generalized tonic­clonic seizures, Neurologic symptoms ranged from blurred vision and headache in 8 patients to focal neurologic deficits, including total blindness, dystaxia, and dysarthria in 2 patients, On T2 weighted images, MRI revealed high intensity lesions which were bilateral in each case. The lesions were predominantly cortical and subcortical with occasional deep white matter lesions, The location and size of the lesions did not correlate with the clinical findings. Follow-up revealed complete resolution of the neurologic symptoms as well as resolution of all MRI lesions,CONCLUSION: Cranial MRI in patients with eclampSia typically reveal high signal lesions on T2 weighted images, The location of the lesions does not correlate with the clinical findings.

REIIAL PELYICAlYCEAl DILATlIII 1M AllTEPARTUI PYELIIIEPHRITIS: IA.TRASa.II) FIMDIIIGS_ DianeM, Twickler. M.D.,x Bertis B. littLe, Ph.D., x Andrew J. Satin, M.D • .x and Charles E.L. Brown, M.D. Departooents of Obstetrics and Gynecology and RadioLogy, The University of Texas southwestern Medical Center, DaLlas, Texas.

Pyelonephritis c"""l icates 2% of pregnancies and many patients lack predisposing factors. This study was Lfldertaken to detel'lline whether or not pregnant ...-en with pyelonephritis have differences of their pelvicalyceal systems c....,ared to nol'lllll controLs. Ul trasound of the right kidney performed on 25 WOllen with cl inical right pyelonephritis and positive urine cultures was c....,ared to controls matched for gestational age, parity, and race. Images were obtained in coronal and axial planes. Woonen with pyelonephritis had increased di lation of the calyceal syst ... c....,ared to controls (1.6 em vs. 0.79 em, P 3 0.001). R~l pelvis vollJlle was increased as weLL (28.2 cm VII. 5.6 em, P <.001). Renal pelvicalyceaL dilation in antepart .... pyelonephritis is significantly increased c....,ared with nonnal physiological dilation of pregnancy. Further studies are necessary to determine whether or not the dilation antedates the pyelonephritis, or is a sequelae of the renaL insult.

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530 EPIDEMIOLOGY OF GESTATIONAL DIABETES. GS BerkowitzX , RH Lapinskix , CJ Lockwood, RL Berkowitz, Mount Sinai School of Medicine, New York, N,Y. 10029.

Little is known about the racial/ethnic distribution of gestational diabetes. Epidemiologic characteristics of gestational diabetes were assessed in 20,894 consecutive patients who had undergone standardized screening. The overall prevalence rate of gestational diabetes was 5.3%. The rate was highest among Orientals (9.9%), followed by Hispanics (5.8%), whites (4.9%) and blacks (4.9%), Among Hispanics, the rate was in­creased for those born in Puerto Rico (9,4%) or outside the U,S. (8,2%), The rate also increased with maternal age, parity and pre gravid weight and was higher for those delivered on the clinic as compared to the private service, In logistic regression analysis, Oriental race, Hispanics born outside of U,S., advancing maternal age, low parity, clinic service and obesity were significantly associated with gestational diabetes. These data suggest that in addition to older maternal age and obesity, risk factors for gestational diabetes should in­clude Orientals, first-generation Hispanics, and low socioeconomic status women.

531 PLACENTA PREVIA NOT ASSOCIATED WITH PRIOR LOW SEGMENT CESAREANS. Y Renfroex, R Jelsemax, R Bhatia, S Bottoms, I Zador", and R Sokol. Wayne State University, Hutzel Hospital, Detroit, MI.

Increased frequencies of placenta previa have been reported with increasing age, parity, prior cesarean section, and prior uterine curettage. To better determine the risks for placenta previa, we examined these factors and other clinical characteristics of 3882 patients who had ultrasound examinations after 28 weeks gestation and delivery in our institution. Of these, 58 had total or partial previa, all proven at cesarean. Data were analyzed using stepwise discriminant analysis,

Step 0 Final Step F F P

Parity 20,9 20,9 0,001 Elective abortion 15.9 14,3 0,001 Classical cesarean 8,8 7,0 0,05 Lower cesarean O,g 2,0 NS Maternal age 5,8 0.01 NS Previous previa 0,8 0.07 NS Spontaneous ab 11,3 3,7 NS

Increasing parity and previous elective abortion were confirmed as significant risk factors, However, only classical cesareans were associated with an increased frequency of placenta previa; lower segment operations, whether transverse or vertical, appeared to be unrelated.