[Pregnancy and delivery course in patients with gestational diabetes mellitus]

The aim of the study was to assess mother and fetal outcome in gestational diabetic women.

The study covered 689 patients with gestational diabetes mellitus. All women had been taken care of II Department of Obstetrics and Gynecology Warsaw Medical University in 1997-2001 years. The following parameters were analyzed: the patients ages, past obstetric experience, gestational age of GDM diagnosis, pregnancy complications, delivery course and neonatal outcomes.

Among study group 11.9% patients required insulin to maintain blood glucose concentration in normal range. GDM was mostly (44.1%) diagnosed between 29 and 34 weeks of pregnancy. At the recommended gestational age of screening tests--24-28 weeks--there were detected only 33.4% GDM. The most frequent pregnancy complication was imminent preterm delivery (16.7%). Delivery at term occurred of 89.1% of cases. Percentage of preterm deliveries was 10.9%. Spontaneous vaginal deliveries were the most frequent (72.5%). 23.2% women were delivered by Cesarean section. The most frequent indication of surgical labor were the symptoms of intrauterine fetal asphyxia (35.6%) and cephalo-pelvic disproportion (26.3%). Most of the newborn (83.3%) had normal birth weight between 2500 g and 4000 g. Among infants the most frequent complications were: hyperbilirubinemia (17.3%) and hypoglicemia (15.6%). Intranatal death occurred in 0.1% of cases, whereas neonatal death--0.4%. Congenital defects were found in 4.3% of all offspring. The most frequent congenital malformation was heart defect--1.3% of newborns (almost half of all congenital defects)

Early diagnosis of gestational diabetes mellitus and specialists obstetric surveillance prevent of pregnancy complications and perinatal mortality, morbidity.