[Diabetic retinopathy and nephropathy--complications in pregnancy and labor].
The purpose of this retrospective study was to determine the risk factors for the morbidity of the mothers and their fetus in patients with diabetic retinopathy and/or nephropathy with an open family planning. We compared the course of pregnancies, complications as well as the maternal and neonatal morbidity in 76 patients with diabetic retinopathy or nephropathy (White R F) with 85 patients without severe microangiopathy (White C D). We found a correlation between retinopathy progression and hyperglycaemia during the first trimester (p < 0.05). There was an increase in the deterioration of visual acuity up to blindness due to the progression of this microangiopathy in cases of proliferative retinopathy. There was a significant increase of the mean diastolic blood pressure (mdp) and preeclamptic symptoms occurred in 71% of the cases with severe microangiopathy (p < 0.05). Deterioration of the diabetic nephropathy with excessive proteinuria (> 10 g/d) and unmanageable hypertension or a progression of the retinopathy led to an earlier delivery in 80% of the patients (p < 0.05). A high rate of preterm deliveries (39%) and a frequent occurrence of intrauterine growth retardation's (9%) characterised the fetal outcome. The following examinations for a patient with an open family planning, if diabetes is diagnosed during childhood or the course of the disease is between 10 and 15 years, should be done: Ophthalmological evaluation, control of the renal function, contraceptive advice and an improvement of the metabolic situation. In case of a diabetic nephropathy in combination with hypertonus the patients shoud be warned against pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)
Hopp
H
H
Klinikum Frauenklinik und Poliklinik, Benjamin Franklin, FU Berlin.
Vollert
W
W
Ebert
A
A
Weitzel
H
H
Glöckner
E
E
Jährig
D
D
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000517:prevention & control; D003928:Diabetic Nephropathies / Q000097:blood / Q000175:diagnosis* / Q000517:prevention & control; D003930:Diabetic Retinopathy / Q000097:blood / Q000175:diagnosis* / Q000517:prevention & control; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood / Q000175:diagnosis / Q000517:prevention & control; D005320:Fetal Macrosomia / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007231:Infant, Newborn; D007744:Obstetric Labor Complications / Q000097:blood / Q000175:diagnosis* / Q000517:prevention & control; D007752:Obstetric Labor, Premature / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D011225:Pre-Eclampsia / Q000097:blood / Q000175:diagnosis / Q000517:prevention & control; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood / Q000175:diagnosis* / Q000517:prevention & control; D011295:Prenatal Care; D012307:Risk Factors
D001786:Blood Glucose