[Monitoring the pregnant diabetic patient]

Abstract

Despite improved surveillance of pregnant diabetic women perinatal mortality and morbidity remains higher than in the general population. Low detection rates of patients with gestational diabetes represent one of the main reasons as screening programs based upon the presence of risk factors only comprise 30% of all women with gestational diabetes. Concerning maternal risks in patients with insulin-dependent diabetes mellitus the incidence of pregnancy induced hypertension is increased up to 12-28%. Macrosomia (6-32%) and malformations (1.5-6%) are the most frequent fetal complications and depend on the quality of controlling the blood glucose level. However, the decrease of fetal and maternal risks requires a general screening program for gestational diabetes as well as an intensive surveillance of the mother and the fetus by an obstetrician and internal specialist, respectively. Delivery of pregnant diabetic women should preferable be performed in specialized hospital units.