Naslov
Management of delivery of type-1 diabetic mother

Autori
Ivanišević, Marina ; Đelmiš, Josip ; Bljajić, Danko ; Ljubas, Nikica

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
20th European Congress of Perinatal and Neonatal Medicine : Book of Abstracts ; u: The Journal of Maternal-Fetal & Neonatal Medicine 19 (2006) (S1) 1-148 / Hajek, Zdenek ; Zoban, Petr - London : Delhi : Taylor & Francis, 2006, 71-72

Skup
European Congress of Perinatal and Neonatal Medicine (20 ; 2006)

Mjesto i datum
Prag, Češka Republika, 24.05.2006. - 27.05.2006

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
pregnancy; DM type 1; delivery

Sažetak
Diabetes in pregnancy causes many problems both for a mother and a child. Patients and methods. In ten years period (1995 - 2004) 396 pregnant patients with type-1 diabetes mellitus were delivered. Following data were analyzed: age of patients, body mass index, weight gain during pregnancy, number and outcome of previous pregnancies, levels of HbA1c in each trimester of pregnancy, complications of labor and delivery, new born weight and height, perinatal mortality and morbidity, placental weight and patohistologycal findings. For statistical analyses we used statistical program SPSS vr. 10. The aim of the study was to analyze the mode of delivery, perinatal outcome in relation to gestational weeks, complications of diabetes mellitus and complications of pregnancy. Results. 396 type-I diabetic patients delivered 398 new born children (2 pregnancies with twins). 309 pregnant type-I patients were without diabetic complications, 29 pregnant patients with non proliferative retinopathy, 23 patients with proliferative retinopathy, 5 patients with peripheral neuropathy and 30 patients with clinically manifest nephropathy. Premature labor occurred in 81 out of 396 deliveries (21.5%) of type-1 diabetic women. Among premature delivered patients the rate of elective preterm delivery was 16.6% what is explained with increased incidence of other complications of pregnancy like fetal in compromise (n=35 ; 43.2%) and super-imposed pre eclampsia (n=31 ; 38.3%). In 15 (18.5%) out of 81 prematurely delivered pregnant diabetic patients pregnancy was terminated earlier than 37 week of gestation because of contractions. The incidence of respiratory distress syndrome in premature new born children was 14.8% (n=12). There were 93 (23.6%) spontaneous vaginal deliveries, 7 (1.8%) deliveries finished by vacuum extraction, and by cesarean section delivered 296 (74.7%) type-1 diabetic patients. There were 23 (5.8%) SGA newborns, 269 (67.6%) AGA newborns, and 106 (26.6%) LGA newborns. Perinatal mortality was 3.3% (n=13 ; 8 stillbirth and 5 neonatal death). Congenital malformations occurred in 10 (2.5%) newborns: one child with Potter' syndrome, 6 children with congenital heart malformation, one child with prosencephaly, and two children with multiple malformations. Four children with congenital malformations died in early neonatal period. During labor and delivery two complications were diagnosed: placental abruption and silent uterus [scare] rupture after previous cesarean section. In postpartum period 16% patients developed endometritis, and one patient developed deep venous thrombosis. Conclusion. The type-I diabetic pregnant patients must be considered a high risk obstetric patients and delivered in the unit that can provide experienced obstetric care, continuous fetal monitoring, and neonatal intensive care.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

Napomena
Doi: 10.1080/14767050600747348. Rad je kao poster prezentiran i na skupu 37th Annual DPSG Meeting, održanom od 15.-18.09.2005.g., Mikonos, Grčka ; objavljen u Kjizi sažetaka ; Christos Zoupas (ur.) ; Athena, 2005. ; 60-60.

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