Management of diabetic pregnancy and its outcome

ABSTRACT

To find out the effect of optimal management of diabetes during pregnancy on maternal morbidity and perinatal morbidity and mortality. A prospective study of 171 consecutive admissions of diabetic pregnant women to Antenatal Ward of Gynaecology and Obstetrics, Unit II, Punjab Medical College [P.M.C.], Divisional Headquarter Hospital [D.H.Q.] Faisalabad. Setting: Antenatal Ward of Gynaecology and Obstetrics, Unit II, P.M.C., D.H.Q. Hospital, Faisalabad. One hundred and seventy one pregnant women with diabetes admitted in Antenatal Ward. Maternal morbidity, perinatal morbidity and mortality and causes of perinatal mortality. One hundred and seventy one cases of pregnancy with diabetes were booked for antenatal care. One hundred and forty five cases continued follow-up and were managed till delivery, one hundred and sixteen [77%] were booked in third trimester, 26 [17%] in second trimester, 8[5%] in first trimester. Hospital and home blood glucose monitoring was carried out. Two cases ended in first trimester abortion. More than half [59%] patients were delivered by caesarean section. Perinatal mortality was 4.82% with equal incidence of congenital malformations and unexplained still births. Diabetes is an important medical complication of pregnancy. Prenatal counseling for established diabetics, screening for diabetes for all pregnant women, good control of diabetes from conception till delivery, antepartum fetal surveillance and good neonatal care by neonatologists are the keys to successful outcome: