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. 2017 Oct-Dec;43(4):376-380.
doi: 10.12865/CHSJ.43.04.15. Epub 2017 Dec 28.

Prenatal, Obstetric and Perinatal Aspects in Pregnancy Associated with Pregestational Diabetes

A V Tetileanu  1 , C Berceanu  2 , Ș Paitici  3 , Loredana Elena Ciurea  4 , Sabina Berceanu  2
Affiliations

Prenatal, Obstetric and Perinatal Aspects in Pregnancy Associated with Pregestational Diabetes

A V Tetileanu et al. Curr Health Sci J. 2017 Oct-Dec.

Abstract

We report the case of a 37-year old primigesta, primipara (IGIP) patient with a singleton, naturally obtained pregnancy, diagnosed with type I diabetes mellitus from the age of three, carrier of an insulin pump for 11 years. The patient was diagnosed in adolescence with with a tumor of the ischio-rectal fossa with multiple attempts of excision which failed due to the particular situation of the tumor. Ultrasound examination diagnosed in the first trimester of pregnancy a voluminous right ovarian cystic tumor. The patient presented pregnancy-induced hypertension starting with 28 gestational weeks. Maternal-fetal and obstetric management assumed sequential ultrasound examination, ovarian tumor and maternal blood pressure drug control, and also the surgical management of the ischio-rectal tumor. Cesarean section was performed at 38 gestational weeks, outcoming with a live fetus, normal weight, good neonatal progression and favorable postoperative progression of the mother. In this case report, we emphasize the fact that in pregestational diabetes mellitus and pregnancy-induced hypertension, constant glycemic control, performed by the insulin pump, prior and during gestation, and the maternal blood pressure control are essential for maternal-fetal outcome.

Keywords: blood pressure control; glycemic control; insulin pump; ischio-rectal tumor; surgery.

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Figures

Figure 1
Figure 1
Transvaginal scan at 8 weeks (+2 days) demonstrating the embryo (green arrow), amniotic sac (white arrow) and the extraembryonic coelom. B. Transvaginal scan at 8 weeks (+2 days) demonstrating the Yolk sac. C. Transabdominal, sagittal scan at 12 weeks (+2 days) showing normal aspects
Figure 2
Figure 2
Systematic evaluation of the right ovarian cyst in the first and second trimester of pregnancy demonstrating its favorable evolution
Figure 3
Figure 3
A. Second-trimester anomaly scan. Dual image (2D and color Doppler). The heart is seen in a lateral four-chamber view, demonstrating normal ventricular septum and normal cardiac anatomy. B. 3D rendering demonstrating normal fetal spine
Figure 4
Figure 4
A. Middle cerebral artery (MCA) Doppler in the third trimester demonstrating normal flow. B. Umbilical artery (UA) Doppler in the third trimester interrogated close to the placental end of the cord, demonstrating normal flow
Figure 5
Figure 5
Transvaginal scan demonstrating the increasing in size bulky ischio-rectal tumor at 32 and 34gw
See this image and copyright information in PMC

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