[Diabetes before pregnancy, apropos of 143 cases]

Autor: F, Jouatte, B, Aitken, P, Dufour, A S, Valat, A, Vamberghe, J P, Cappoen, R, Leroy, F, Puech, J C, Monnier
Jazyk: francouzština
Rok vydání: 2000
Předmět:
Zdroj: Contraception, fertilite, sexualite (1992). 27(12)
ISSN: 1165-1083
Popis: The authors want to appraise the management of diabetes prior to pregnancy in a local population treated in the Lille University Hospital.This is a retrospective study of 143 pregnancies occurring in 111 patients with diabetes prior to pregnancy, between 1987 and 1997, in the Obstetrics Department at the Lille University Hospital.Only one-third of the patients benefited from preconception management; the stability of diabetes during the first trimester was satisfactory in 50% of the cases. The maternal complications are represented by preeclampsia (20%), metabolic complications specific to diabetes (hypoglycemia, ketoacidosis), the aggravation or the emergence of a retinopathy (10%) and polyhydramnios (19%). Concerning the termination of the pregnancies, of the 147 fetuses (four twin pregnancies), 140 newborns in good health, two neonatal deaths, three in-utero deaths and two therapeutic terminations of pregnancy were observed. The fetal malformation rate was 9.5% (14 cases/147). The cesarean section rate was 63%, whereas the fetal macrosomatia rate was 35%, with dystocia in 26% of the deliveries (outside of planned cesareans). Three shoulder dystocia were observed (two requiring the Jacquemier's maneuver and one with transitory plexus brachial palsy for a newborn weighing 5,650 g).The authors conclude that preconception management (one-third of the patients in this series) and management of during the first trimester of pregnancy (50% in this series) was insufficient. This fact is perhaps due to the confusion, for many practitioners, with gestational diabetes, which is a very mediatized affection, though much less severe for the fetus and mother.
Databáze: OpenAIRE