Diabetes in pregnancy

Abstract

Despite the dramatic decline in maternal and perinatal morbidity and mortality over the past few decades, controversy still exists regarding the care of pregnant women with both pregestational and gestational diabetes mellitus. Carbohydrate intolerance is the most common metabolic complication of pregnancy. A review of the literature over the last two decades indicates that the incidence of gestational diabetes mellitus (GDM) varies from 0.15-12.3%. Between 0.2 and 0.3% of pregnancies occur in women with insulin dependent diabetes mellitus (IDDM). When not diagnosed and treated properly, diabetes in pregnancy is associated with adverse maternal and fetal outcome; such as high perinatal wastage, congenital anomalies, macrosomia, and neonatal, childhood and adult complications. The main problems regarding maternal-fetal outcome in pregnancy complicated by diabetes can be divided into three main categories: the pathophysiology of the metabolic state in pregnancy and its implications on the mother and the conceptus. This presentation dealing with feto-maternal outcome of these high risk pregnancies will discuss accelerated fetal growth, congenital anomalies, future obesity and diabetes in babies born to GDM and pre-GDM mothers and future maternal diabetes in GDM and vascular complications in pre-GDM. Our organized team approach combined with intensive monitoring and therapy throughout pregnancy which has achieved successful results in women with complicated diabetes will be presented.