Sudden fetal death in women with well-controlled, intensively monitored gestational diabetes.
An intensive antepartum monitoring system for women with gestational diabetes mellitus was evaluated over a 5-year period. Early diagnosis and liberal treatment with insulin was concomitantly followed with non-stress testing: weekly from 28 to 34 weeks' gestation and semi-weekly thereafter. Despite maternal euglycemia and satisfactory antepartum assessment, three fetal deaths occurred within 72 hours of reassuring fetal monitoring. Additionally, 24 (7%) fetuses were delivered on the basis of a low biophysical profile score (less than 6) at term. The stillbirth rate for women with gestational diabetes was 7.7/1000, whereas the stillbirth rate for nondiabetic low-risk patients was 4.8/1000. Women with gestational diabetes continue to be in a high-risk category for antepartum fetal death, requiring intensive monitoring with consideration for timely delivery.
Girz
B A
BA
Weiler Hospital, Albert Einstein College of Medicine, Bronx, NY.
Divon
M Y
MY
Merkatz
I R
IR
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D003645:Death, Sudden; D003922:Diabetes Mellitus, Type 1 / Q000097:blood; D016640:Diabetes, Gestational / Q000097:blood; D005188:False Negative Reactions; D005260:Female; D005313:Fetal Death; D005323:Fetal Monitoring; D006801:Humans; D011247:Pregnancy
D001786:Blood Glucose