Since the available data on growth in twin gestations have been derived from retrospective cross-sectional studies with varying results, a prospective longitudinal study was initiated to assess fetal head growth in twin gestations as compared to singleton pregnancies. In uncomplicated twin gestations, growth of the fetal head, based on the increment in growth over time and the rate of growth throughout pregnancy, was found not to be significantly different than in singleton pregnancies. In light of these findings, current nomograms derived from measurements obtained in singleton pregnancies remain useful for evaluating fetal head growth in twin gestations.

The oral glucose tolerance test is the recommended method for the assessment of carbohydrate metabolism in pregnancy. However, available glucose drinks are often associated with varying degrees of gastrointestinal symptoms that might preclude meaningful studies. Polycose (Ross Labs, Columbus, Ohio) is a glucose saccharide polymer mixture containing 3% glucose, 7% maltose, 5% maltotriose, and 85% polysaccharide of 4 to 15 glucose units, with an osmotic load one fifth that of glucose. We assessed the efficacy of this glucose polymer in the performance of a 3-hour carbohydrate tolerance test with glucose and glucose polymer used 3 to 5 days apart in each patient tested. After 2 days of 300 gm carbohydrate-enriched diets, 48 patients underwent 3-hour carbohydrate tolerance tests at a mean gestational age of 30 +/- 3 weeks. Statistical analysis revealed a moderate level of agreement (kappa = 0.45, p less than 0.001) between the results of both carbohydrate tolerance test preparations. Patients experienced fewer gastrointestinal symptoms with the glucose polymer than with glucose. These preliminary data suggest that glucose polymer may be effectively used in the performance of a 3-hour carbohydrate tolerance test.

Although the 1-hour 50 gm blood glucose screening test is an effective way of detecting diabetes in pregnancy, the taste of available glucose drinks often creates gastrointestinal symptoms and leads to refusal of the patient to be tested. The efficacy of a virtually tasteless glucose polymer in testing carbohydrate tolerance in pregnancy was determined. Sixty-one pregnant patients undergoing screening for gestational diabetes underwent a 1-hour carbohydrate tolerance test of both glucose and a glucose polymer within 3 days of each other. Analysis of the data revealed a high degree of agreement between the results of the 1-hour carbohydrate tolerance test (k = 0.62, p < 0.0001). These data suggest that glucose polymer can be used effectively in screening for gestational diabetes.