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Obstetric care in diabetic pregnancy
In diabetic pregnancy near-normalization of maternal blood glucose levels improves the perinatal outcome. Strict metabolic control can be achieved by self-monitoring of blood glucose in ambulant praxis. The obstetric supervision may now therefore be organized on an out-patient basis aiming at early recognition of pregnancy complications such as preeclampsia and deviation in fetal growth. For uncomplicated and well-controlled diabetes without vascular complications the obstetric care should be individualized and routine programmes for obstetric surveillance, such as fetal heart rate monitoring and determination of fetal maturity, are usually not necessary. Special attention should, however, be paid to patients with poor metabolic control or vascular complications, particularly in the presence of disturbances of intra-uterine growth.
In diabetic pregnancy near-normalization of maternal blood glucose levels improves the perinatal outcome. Strict metabolic control can be achieved by self-monitoring of blood glucose in ambulant praxis. The obstetric supervision may now therefore be organized on an out-patient basis aiming at early recognition of pregnancy complications such as preeclampsia and deviation in fetal growth. For uncomplicated and well-controlled diabetes without vascular complications the obstetric care should be individualized and routine programmes for obstetric surveillance, such as fetal heart rate monitoring and determination of fetal maturity, are usually not necessary. Special attention should, however, be paid to patients with poor metabolic control or vascular complications, particularly in the presence of disturbances of intra-uterine growth.