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[Diabetes and pregnancy]

G Biesenbach1

  • 1Medizinische Abeteilung des Allgemeinen Krankenhauses, Stadt Linz.

Wiener Klinische Wochenschrift
|January 1, 1996
PubMed
Summary
This summary is machine-generated.

Diabetic pregnancies face ongoing risks despite reduced mortality. Optimal control improves outcomes, but complications like nephropathy and retinopathy still elevate perinatal morbidity and mortality.

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Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Perinatology

Background:

  • Perinatal mortality in diabetic pregnancies has significantly decreased.
  • Optimal metabolic control and absence of diabetic angiopathy lead to perinatal survival rates comparable to normal pregnancies.
  • However, achieving adequate metabolic control throughout gestation and managing pre-existing diabetic angiopathy remain challenges, contributing to future elevated risks.

Purpose of the Study:

  • To review the current status and future outlook of perinatal mortality and morbidity in diabetic pregnancies.
  • To highlight the impact of specific diabetic complications, such as nephropathy, retinopathy, and macroangiopathy, on pregnancy outcomes.
  • To discuss the advancements in managing these high-risk pregnancies.

Main Methods:

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  • Literature review of recent advancements in managing diabetic pregnancies.
  • Analysis of perinatal outcomes in relation to maternal diabetic complications.
  • Synthesis of data on mortality and morbidity trends.

Main Results:

  • While perinatal mortality has decreased, perinatal morbidity remains a concern, especially in cases of diabetic nephropathy.
  • Pre-existing diabetic nephropathy increases risks of progression, gestosis, and intrauterine growth retardation, often necessitating early delivery.
  • Diabetic retinopathy may worsen during pregnancy, and macroangiopathy, particularly coronary artery disease, poses significant cardiovascular risks.
  • Acute myocardial infarction in pregnant diabetics is associated with high maternal and fetal mortality.

Conclusions:

  • Despite improvements, diabetic pregnancy continues to be associated with elevated perinatal mortality and morbidity.
  • Careful management of metabolic control and pre-existing complications is crucial.
  • Further research and clinical strategies are needed to mitigate risks, particularly concerning nephropathy and cardiovascular complications.