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Prenatal, Obstetric and Perinatal Aspects in Pregnancy Associated with Pregestational Diabetes

A V Tetileanu1, C Berceanu2, Ș Paitici3

  • 1Department of Obstetrics and Gynecology, Emergency County Hospital Târgu-Jiu, Romania; Doctoral School, University of Medicine and Pharmacy Craiova, Romania.

Current Health Sciences Journal
|January 1, 2019
PubMed

Insights

This case report highlights successful management of a pregnant patient with type I diabetes and hypertension. Effective glycemic control with an insulin pump and blood pressure management were crucial for a positive maternal-fetal outcome.

Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Surgical Oncology

Background:

  • A 37-year-old patient with type I diabetes mellitus (diagnosed at age 3, on insulin pump for 11 years) and a history of ischio-rectal fossa tumor presented with a singleton pregnancy.
  • The patient developed pregnancy-induced hypertension at 28 weeks gestation and had a diagnosed right ovarian cystic tumor in the first trimester.

Purpose of the Study:

  • To describe the management of a complex pregnancy involving pregestational diabetes mellitus, pregnancy-induced hypertension, an ovarian tumor, and a pre-existing ischio-rectal fossa tumor.
  • To emphasize the importance of meticulous glycemic and blood pressure control for favorable maternal-fetal outcomes in high-risk pregnancies.

Main Methods:

  • Sequential ultrasound examinations for monitoring the ovarian tumor and fetal development.
  • Pharmacological management of pregnancy-induced hypertension.
  • Surgical management of the ischio-rectal fossa tumor.
  • Continuous glycemic control using an insulin pump prior to and throughout gestation.

Main Results:

  • Cesarean section was performed at 38 weeks gestation, resulting in a live, normal-weight infant with good neonatal progression.
  • The mother experienced a favorable postoperative recovery.
  • Effective management of diabetes and hypertension contributed to a successful maternal-fetal outcome.

Conclusions:

  • Constant glycemic control via insulin pump therapy and vigilant blood pressure management are essential for optimizing maternal-fetal outcomes in patients with pregestational diabetes mellitus and pregnancy-induced hypertension.
  • Multidisciplinary management is key for addressing complex obstetric cases with co-existing conditions.

Keywords:
blood pressure controlglycemic controlinsulin pumpischio-rectal tumorsurgery

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