Surveillance of pregnant diabetics--comparison between outpatient and inpatient management

From 1982 to 1993 67 diabetic women attended the University Women's Hospital obstetric clinic at Würzburg. These women were separated into two groups: group 1 (inpatient group) delivered between 1/82 and 7/87, group 2 (outpatient group) delivered between 8/87 and 4/93. Between 1982 and 1987 we used extensive inpatient care. But did not so after 1987. The fetus was monitored by ultrasound scans, cardiotocography, oxytocin stress test and doppler measurements. Nearly all patients used home blood glucose monitoring. We compared blood glucose levels, mode of delivery and fetal outcome for the two groups. There was no significant difference in the average blood glucose levels between the two groups. Cesarean section rates (37%) and gestational age at delivery (37 weeks) were similar in both groups. Fetal macrosomia (birth weight > 4000 g) occured more frequently in the outpatient group (group 1: 4%, group 2: 25%, P < 0.01). This fact did not effect perinatal morbidity. Postnatal metabolic disorders did not increase. Fetal anomalies occurred less frequently in the outpatient group (group 1: 7%, group 2: 2%, P < 0.05).