Clinical aspects of diabetes in pregnancy

The introduction of insulin produced a rapid improvement in the maternal prognosis in pregnancy associated with diabetes mellitus. Within years, maternal mortality fell from 50% and has become a rarity. Improvement in fetal survival was less dramatic until the work of Pedersen (1952); Peel and Oakley (1950) and White (1949) demonstrated that with determined antenatal control of diabetes the fetal outcome was greatly improved. Further improvement in the care of the fetus of the pregnant diabetic with fetal monitoring, both ante- and intra-partum, together with modern neonatal expertise, had brought the perinatal and neonatal morbidity and mortality for this group of patients close to that of the non-diabetic. An account is given of the author's present day practice in this group of patients.