Outcome of Diabetic Pregnancy With Spontaneous Labour After 38 Weeks
Previously, the risk of intrauterine death in term infants of diabetic mothers led to elective delivery at 38 weeks, after confirmation that the lungs were mature. This study looked at perinatal outcomes in 148 women with well-controlled insulin-dependent diabetes who were allowed to enter labor spo...
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| Veröffentlicht in: | Obstetrical & gynecological survey 2000-05, Vol.55 (5), p.266-268 |
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| creator | McAuliffe, F M Foley, M Firth, R Drury, I Stronge, J M |
| description | Previously, the risk of intrauterine death in term infants of diabetic mothers led to elective delivery at 38 weeks, after confirmation that the lungs were mature. This study looked at perinatal outcomes in 148 women with well-controlled insulin-dependent diabetes who were allowed to enter labor spontaneously. All of them had reached 38 weeks with a live fetus, no obstetrical complications, and fasting blood glucose levels of 3 to 5 mM/liter (with 2-hour postprandial levels |
| doi_str_mv | 10.1097/00006254-200005000-00003 |
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This study looked at perinatal outcomes in 148 women with well-controlled insulin-dependent diabetes who were allowed to enter labor spontaneously. All of them had reached 38 weeks with a live fetus, no obstetrical complications, and fasting blood glucose levels of 3 to 5 mM/liter (with 2-hour postprandial levels <7 mM/liter) through most of the pregnancy. One-third of the group were primigravidas. Half of the women delivered between 38 and 39 weeks’ gestation, and the rest delivered at 40 to 42 weeks’ gestation. Instrumental delivery was performed in 9 percent of cases, and cesarean delivery was performed in 7 percent.The two perinatal deaths yielded a perinatal mortality rate of 13.5 per 1000. Twenty-one infants, 14 percent of those born, required admission to a special care unit. The major differences from the general hospital population were a higher rate of operative delivery in labor (7 vs. 3.4 percent) and a higher proportion of newborn infants weighing 4 kg or more (33 vs. 18 percent). Nevertheless, there was only one case of shoulder dystocia in the diabetic group. In a larger group of 373 insulin-dependent diabetic women, from whom the study population was selected, the perinatal mortality was 3-fold greater than in the general hospital population (32 vs. 10.6 per 1000). In the well-controlled diabetic patients, the last glycosylated hemoglobin level before delivery did not predict either high birth weight or the need for cesarean delivery.Vaginal delivery is the norm in well-controlled women with insulin-dependent diabetes who are allowed to enter labor spontaneously after 38 weeks’ gestation. Perinatal morbidity and mortality are not excessive, and the risk of shoulder dystocia is not increased.Ir J Med Sci 1999;168:160–163</description><identifier>ISSN: 0029-7828</identifier><identifier>EISSN: 1533-9866</identifier><identifier>DOI: 10.1097/00006254-200005000-00003</identifier><language>eng</language><publisher>Lippincott Williams & Wilkins, Inc</publisher><ispartof>Obstetrical & gynecological survey, 2000-05, Vol.55 (5), p.266-268</ispartof><rights>2000 Lippincott Williams & Wilkins, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>McAuliffe, F M</creatorcontrib><creatorcontrib>Foley, M</creatorcontrib><creatorcontrib>Firth, R</creatorcontrib><creatorcontrib>Drury, I</creatorcontrib><creatorcontrib>Stronge, J M</creatorcontrib><title>Outcome of Diabetic Pregnancy With Spontaneous Labour After 38 Weeks</title><title>Obstetrical & gynecological survey</title><description>Previously, the risk of intrauterine death in term infants of diabetic mothers led to elective delivery at 38 weeks, after confirmation that the lungs were mature. This study looked at perinatal outcomes in 148 women with well-controlled insulin-dependent diabetes who were allowed to enter labor spontaneously. All of them had reached 38 weeks with a live fetus, no obstetrical complications, and fasting blood glucose levels of 3 to 5 mM/liter (with 2-hour postprandial levels <7 mM/liter) through most of the pregnancy. One-third of the group were primigravidas. Half of the women delivered between 38 and 39 weeks’ gestation, and the rest delivered at 40 to 42 weeks’ gestation. Instrumental delivery was performed in 9 percent of cases, and cesarean delivery was performed in 7 percent.The two perinatal deaths yielded a perinatal mortality rate of 13.5 per 1000. Twenty-one infants, 14 percent of those born, required admission to a special care unit. The major differences from the general hospital population were a higher rate of operative delivery in labor (7 vs. 3.4 percent) and a higher proportion of newborn infants weighing 4 kg or more (33 vs. 18 percent). Nevertheless, there was only one case of shoulder dystocia in the diabetic group. In a larger group of 373 insulin-dependent diabetic women, from whom the study population was selected, the perinatal mortality was 3-fold greater than in the general hospital population (32 vs. 10.6 per 1000). In the well-controlled diabetic patients, the last glycosylated hemoglobin level before delivery did not predict either high birth weight or the need for cesarean delivery.Vaginal delivery is the norm in well-controlled women with insulin-dependent diabetes who are allowed to enter labor spontaneously after 38 weeks’ gestation. 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This study looked at perinatal outcomes in 148 women with well-controlled insulin-dependent diabetes who were allowed to enter labor spontaneously. All of them had reached 38 weeks with a live fetus, no obstetrical complications, and fasting blood glucose levels of 3 to 5 mM/liter (with 2-hour postprandial levels <7 mM/liter) through most of the pregnancy. One-third of the group were primigravidas. Half of the women delivered between 38 and 39 weeks’ gestation, and the rest delivered at 40 to 42 weeks’ gestation. Instrumental delivery was performed in 9 percent of cases, and cesarean delivery was performed in 7 percent.The two perinatal deaths yielded a perinatal mortality rate of 13.5 per 1000. Twenty-one infants, 14 percent of those born, required admission to a special care unit. The major differences from the general hospital population were a higher rate of operative delivery in labor (7 vs. 3.4 percent) and a higher proportion of newborn infants weighing 4 kg or more (33 vs. 18 percent). Nevertheless, there was only one case of shoulder dystocia in the diabetic group. In a larger group of 373 insulin-dependent diabetic women, from whom the study population was selected, the perinatal mortality was 3-fold greater than in the general hospital population (32 vs. 10.6 per 1000). In the well-controlled diabetic patients, the last glycosylated hemoglobin level before delivery did not predict either high birth weight or the need for cesarean delivery.Vaginal delivery is the norm in well-controlled women with insulin-dependent diabetes who are allowed to enter labor spontaneously after 38 weeks’ gestation. Perinatal morbidity and mortality are not excessive, and the risk of shoulder dystocia is not increased.Ir J Med Sci 1999;168:160–163</abstract><pub>Lippincott Williams & Wilkins, Inc</pub><doi>10.1097/00006254-200005000-00003</doi><tpages>3</tpages></addata></record> |
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| source | Journals@Ovid Complete |
| title | Outcome of Diabetic Pregnancy With Spontaneous Labour After 38 Weeks |
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