Maternal events and perinatal outcomes of pregnant women with diabetes mellitus: Gestational vs. pregestational diabetes mellitus

Background: Diabetes mellitus is the most frequently encountered endocrine disorder in pregnancy and is associated with adverse outcomes if remain undiagnosed or untreated. This study was done to compare the maternal and perinatal outcome of pregestational diabetes mellitus (PGDM) with that of gestational diabetes (GDM). Methods: This observational analytical study with group comparison was carried out in the Department of Obstetrics and Gynaecology, BIRDEM General Hospital, Dhaka from July 2015 to June 2016. This study was conducted on two groups of pregnant women: group A (PGDM) and group B (GDM). A total of 100 cases were selected and in each group 50 pregnant women were enrolled. Singleton pregnancy and age 18 to 45 years were included. Pregnancy with hypertension, heart disease, renal disease and other metabolic disorders were excluded. Results: In this study mean gestational age of the study subjects were 35.72 ± 2.61 weeks and 36.58 ± 2.34 weeks in PGDM and GDM groups. History of GDM [34.0% vs 16.0%], intrauterine death (IUD) [14.0% vs 2.0%] and abortion [22.0% vas 6.0%] were significantly higher among PGDM patients than GDM patients. Regarding present pregnancy complications, polyhydramnios [32.0% vs 14.0%], preterm delivery [38.0% vs 20.0%], vulvovaginitis [28.0% vs 12.0%] and premature rupture of membrane (PROM) [24.0% vs 8.0%] were significantly higher in PGDM than GDM patients. Wound infection was significantly high in PGDM groups [35.7% vs 11.1%] among the patients delivered by lower uterine Cesarean section (LUCS). Regarding perinatal complications, hypoglycemia [22.0% vs 8.0%], birth asphyxia [24.0% vs 8.0%], RDS [24.0% vs 8.0%] were significantly higher among PGDM comparing GDM patients. Conclusion: The maternal and perinatal outcomes of pregestational diabetes mellitus were less favorable than those of gestational diabetes mellitus. Birdem Med J 2019; 9(2): 127-132

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Maternal and perinatal outcomes in diabetic pregnancies at BPKIHS

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20172115 ◽

2017 ◽

Vol 6 (6) ◽

pp. 2262

Author(s):

Anamika Das

Keyword(s):

Diabetes Mellitus ◽

Pregnant Women ◽

Neonatal Outcome ◽

Post Partum ◽

Perinatal Outcomes ◽

Perinatal Complications ◽

Overt Diabetes ◽

Global Pandemic ◽

The Government ◽

Sedentary Life Style

Background: Diabetes has become a global pandemic because of aging population, sedentary life style, urbanization, and increasing incidence of obesity; this study was aimed to identify the maternal and perinatal outcome in Diabetes complicating pregnancies and to compare the outcome in Gestational Diabetes Mellitus and Overt Diabetes Mellitus.Methods: This was a descriptive study conducted from 1st April 2013-31st March 2014 on total 75 pregnant women. All antenatally diagnosed cases of GDM and overt diabetes, booked or unbooked, whoever came for delivery were studied. Both mothers and neonates were followed up in ante-partum, intra-partum, and post-partum period till their stay in hospital. Management of the patient was done as per the hospital protocol.Results: Out of 75 cases enrolled, 25.33% had GDM and 16% had overt diabetes mellitus.57.33%patients were multigravida, among which 40% had GDM and 17.33% had Overt Diabetes Mellitus.61.33% patients underwent LSCS, of which 41.33% had GDM and 20% had overt diabetes mellitus. Obstetric complication was more common in GDM patients (30.66%) compared to Overt (22.66%). 89.33%babies had good neonatal outcome and 10.66% babies (6.66% of GDM mothers and 4% of overt mothers) had poor neonatal outcome (macrosomia, hypoglycaemia, prematurity, respiratory distress with NICU stay and use of antibiotics, poor APGAR (<7 at 5 min), gross congenital malformation, hyperbilirubinemia, stillbirth and neonatal death).Conclusions: Maternal and perinatal complications was commonly seen in diabetic pregnancy though more common in GDM.The time has come for the Government of Nepal to implement an effective plan to the benefit of pregnant women with diabetes during pregnancy.

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Ritodrine Should Be Carefully Administered during Antenatal Glucocorticoid Therapy Even in Nondiabetic Pregnancies

ISRN Obstetrics and Gynecology ◽

10.1155/2013/120735 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Masaki Ogawa ◽

Yoshio Matsuda ◽

Aiko Kobayashi ◽

Etsuko Shimada ◽

Yoshika Akizawa ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Pregnant Women ◽

Glucocorticoid Therapy ◽

Pregestational Diabetes ◽

Ritodrine Hydrochloride ◽

Maternal Hyperglycemia ◽

Computerized Records ◽

Tocolytic Agent ◽

Harmful Effects

Aim. Antenatal glucocorticoid therapy (AGT) has been commonly used recently. However, this therapy has severe harmful effects such as maternal hyperglycemia. In Japan, ritodrine hydrochloride has been used as a tocolytic agent. In this study, we performed retrospective casecontrol study to clarify whether concomitant use of ritodrine and glucocorticoid was safe to pregnant women without diabetes mellitus. Methods. We reviewed the computerized records of pregnant women with pregestational diabetes and nondiabetes who gave birth at our hospital between 2002 and 2011. Cases and controls received AGT. Blood glucose after the therapy was analyzed, and additional volume of insulin was compared to that before the therapy. Results. From this study, 30 units of insulin were necessary when performing AGT in diabetic pregnant women. And also, an increase in blood glucose of 40 mg/dL was seen after the therapy even in nondiabetic pregnant women. Blood glucose increased significantly in the group that also received ritodrine, and it was shown that the number of pregnant women who might develop ketoacidosis might increase 11-fold. Conclusions. Ritodrine should be carefully administered during antenatal glucocorticoid therapy. It may be necessary to adequately monitor blood glucose, when performing the therapy, even in nondiabetic pregnant women.

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Perinatal and neonatal outcomes of pregestational diabetes mellitus: a retrospective study

10.21203/rs.3.rs-555135/v1 ◽

2021 ◽

Author(s):

Giampiero Capobianco ◽

Alessandra Gulotta ◽

Giulio Tupponi ◽

Francesco Dessole ◽

Giuseppe Virdis ◽

...

Keyword(s):

Diabetes Mellitus ◽

Pregnant Women ◽

Gestational Hypertension ◽

Diabetes Mellitus Type 1 ◽

Diabetes Mellitus Type ◽

Control Group ◽

Growth Disorders ◽

Pregestational Diabetes ◽

Increased Risk ◽

History Of

Abstract BackgroundThe aim of the study was to evaluate maternal-foetal and neonatal clinical outcomes in a group of patients with pregestational diabetes mellitus (PGDM) such as diabetes mellitus type 1 (DM1), diabetes mellitus type 2 (DM2), and maturity onset diabetes of the young (MODY).MethodsOverall, 174 pregnant women, nulliparous and multiparous, with single pregnancy were enrolled. The selected patients were divided into two groups: PGDM (42 with DM1, 14 with DM2, and 2 with MODY); 116 patients with a negative pathological history of diabetes mellitus were the control.ResultsWe reported an incidence of preterm delivery of 55.2% in the PGDM group, of 59.5% in the DM1 group, and 42.9% in the DM2 group VS. 6% in the controls. Foetal growth disorders, such as intrauterine growth retardation, small for gestational age, and foetal macrosomia were found in 19% and 3.6% in the case and in the control group, respectively. A relationship between DM2 and gestational hypertension was found.Conclusionspatients with PGDM are at increased risk of perinatal and neonatal complications in comparison with pregnant women without PGDM.

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Oxidative stress in pregnant women with diabetes mellitus

Diabetes Mellitus ◽

10.14341/dm8669 ◽

2018 ◽

Vol 20 (6) ◽

pp. 461-471 ◽

Cited By ~ 1

Author(s):

Roman V. Kapustin ◽

Olga N. Arzhanova ◽

Alena V. Tiselko

Keyword(s):

Oxidative Stress ◽

Diabetes Mellitus ◽

Pregnant Women ◽

Asymmetric Dimethylarginine ◽

Malonic Dialdehyde ◽

Perinatal Outcomes ◽

Abnormal Development ◽

Different Types ◽

Anti Oxidant ◽

Adverse Perinatal Outcomes

Oxidative stress (OS) plays an important role in embryo development, implantation, placentation, fetal development and labour. Diabetes mellitus (DM) is associated with an increase in OS processes. However, the expression of OS biomarkers in pregnant women with DM remains unclear. Based on a literature review, the features of the pro- and anti-oxidant systems of pregnant women with different types of DM have been established. Pregnancy in patients with DM has been shown to be characterised by an activation of OS processes. This leads to an overexpression of free radicals (peroxynitrite), toxic derivatives (malonic dialdehyde, 8-isoprostane) and specific enzymes (asymmetric dimethylarginine, catalase) and a decrease in the synthesis of antioxidants (superoxide dismutase, glutathione peroxidase and uric acid). The modified expression of these biomarkers is observed both in the blood and the placenta of pregnant women. These disorders can cause an unfavourable course of pregnancy, abnormal development of the placenta and development of adverse perinatal outcomes in pregnant women with DM. Nevertheless, given the inconsistency of data obtained, further scientific studies are needed to clarify this issue.

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References Values of Fetal Heart Myocardial Volume by Three-Dimensional Ultrasound using Spatiotemporal Image Correlation and Virtual Organ Computer-Aided Analysis Methods and Their Applicability in Pregestational Diabetic Women

American Journal of Perinatology ◽

10.1055/s-0039-3400983 ◽

2019 ◽

Author(s):

José Francisco Melo Júnior ◽

Nathalie Jeanne Bravo-valenzuela ◽

Luciano Marcondes Machado Nardozza ◽

Alberto Borges Peixoto ◽

Rosiane Mattar ◽

...

Keyword(s):

Diabetes Mellitus ◽

Pregnant Women ◽

Fetal Heart ◽

Three Dimensional ◽

Image Correlation ◽

Interobserver Reproducibility ◽

Pregestational Diabetes ◽

Computer Aided Analysis ◽

Computer Aided ◽

Spatiotemporal Image Correlation

Abstract Objective To determine reference values for myocardial volume of the fetal heart using three-dimensional ultrasound with spatiotemporal image correlation (STIC) and virtual organ computer-aided analysis (VOCAL) and to assess their applicability in women with pregestational diabetes. Study Design This retrospective cross-sectional study included 177 normal pregnant women with fetuses between 200/7 and 336/7 weeks of age. Fetal cardiac volumes were collected using the STIC method, and myocardial volume was obtained by subtraction of the intracavitary volumes using the VOCAL 30-degree method. Intra- and interobserver reproducibility values were determined using the concordance correlation coefficient (CCC). Sixteen women with pregestational diabetes mellitus were evaluated for validation. Results There was a strong correlation between fetal myocardial volume and gestational age (R 2 = 0.82). Intra- and interobserver reproducibility values were excellent and moderate, respectively, with CCCs of 0.99 and 0.83, respectively. There was no significant difference in mean fetal myocardial volume between normal pregnant women and those with pregestational diabetes (p = 0.64). Conclusion Reference values for myocardial volume of the fetal heart were determined in normal pregnant women and were not statistically different from those in women with pregestational diabetes mellitus.

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