Course of pregnancy and delivery in patients with pregestational diabetes mellitus

INTRODUCTION: Pregnancy in a woman with pregestational diabetes mellitus (PGDM) is associated with increased risk of complications in both the mother and the fetus. A close surveillance is strongly recommended in these pregnancies. OBJECTIVES: The aim of the study was to assess perinatal outcome in pregnancies complicated by PGDM. Study design: The study covered 127 pregnancies with PGDM. Apart from perinatal outcome the patient's age, past obstetric history, the duration of perinatal diabetic care and the course of pregnancy were taken into consideration. Diabetes mellitus was classified according to White. RESULTS: 37.8% of patients were diagnosed PGDM B class, 38.6%--C class, 15.7%--D class, 1.6%--F class and 6.3%--RF class. Less than half of women (45.5%) remained under medical care since the first trimester. The arterial hypertension was the most common complication of pregnancy and occurred in over 18% of studied pregnancies. The incidence of preterm delivery was 41.7%. Cesarean section was performed in 55.9% of patients. 16.6% of the neonates had a birth weight below 2500 g. 4 neonates were stillborn (2.4%) and the next 3 ones (2.4%) died within the first month following the delivery. Congenital heart defects were found in 8.7% of offsprings. CONCLUSIONS: Despite the progress in perinatal care pregestational diabetes mellitus is still associated with increased risk of maternal and fetal mortality and morbidity.