Medical termination of unplanned pregnancies in women with diabetes

Women living with diabetes may experience unplanned pregnancies. This poses challenges and risk to both maternal and foetal health in case glycaemia and other associated comorbidities are not optimized. This may lead to doubts regarding continuation of pregnancy, given there are no clear guidelines or position statement for decision regarding termination or continuation of pregnancy. Multiple biomedical, psychosocial and environmental factors determine the course and outcome of such pregnancies. In such situations, a comprehensive analysis of foeto maternal health helps inform the antenatal woman, so that the right decision can be made, in a person-centred manner. This review proposes various algorithms to assist in shared decision making, including a 2x2x2 rubric (Psychosocial: statutory (legal), system-specific; emotional, economic; Biomedical: obstetric, offspring health; medical, metabolic health). No single biochemical value should be taken as an indication for termination of pregnancy, unless the foetus is incompatible with life.