Asma Tanvir Usmani, Nabeela Waheed.
Pregnancy complicated with diabetes: A one year experience.
J Pak Inst Med Sci Jan ;6(1,2):342-5.

A total of 30 women with abnormalities of glucose tolerance were studied and followed up at Holy Family Hospital from November 1992 to October 1993. There were 21 insulin treated pregnancies of whom 13 were insulin dependent diabetics prior to the pregnancy. The remaining 7 pregnancies occurred in women who were diagnosed as gestational diabetics during the pregnancy and were treated with insulin because of persistent preprandial blood glucose concentrations in excess of 6 mmol/1 despite dietary advice. One patient who had impaired glucose tolerance also required insulin. Of the remaining 9 who were euglycemic oil diet alone, 4 had impaired glucose tolerance and 5 had gestational diabetes as diagnosed by 75 gm glucose tolerance test (WHO Criteria). All but 2 pregnancies progressed to term and none were allowed to go beyond 40 weeks. Spontaneous labour was attained in 56.6% of all cases and in 23.3% labour was induced mostly because the patients had completed 40 weeks of gestation. Our caesarean section rate was 43% which compares favourably with international figures. There was one still birth and one neonatal death Perinatal mortality adjusted for lethal congenital anomaly, was 3.3% which compares favorably to 5% rate for most recent series. Our data suggests that strict diabetic control has resulted in a dramatic fall in perinatal mortality in diabetic pregnancies and that this allows a majority of these women to go past 38 weeks of pregnancy, hence allowing spontaneous labours with an increased chance of vaginal delivery.

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