[Gestational diabetes: the Rennes Study of joint obstetrical and endocrinological management].
OBJECTIVE
To assess the efficacy of a co-program of care in gestational diabetes conducted by the obstetrical and endocrinological units of the Rennes South Hospital (Hopital Sud) and the possibility of adapting obstetrical care to existing risk factors.


METHODS
A retrospective analysis was made of 200 cases of gestational diabetes diagnosed between January 1993 and December 1996 in the obstetrical units.


RESULTS
Instrumental extraction and cesarean section were required for 13.5% and 20.5% of the deliveries respectively. Shoulder dystocia occurred in 2%. 19.9% of the infants had macrosomia and 5. 3% were small for gestational age. Neonatal morbidity required transfer to the pediatric intensive care unit for only 2.9% of the infants. Frequency of cesarean section and macrosomia correlated with poor blood glucose control and excess maternal weight for gravidic hypertension. At 3 months post-partum, glucose intolerance and non-insulin-dependent diabetes were diagnosed in 13% and 2% respectively.


CONCLUSIONS
Systemic screening and obstetrical and endocrinological care allowed patients to prevent maternal and fetal complications in gestational diabetes and to initiate hygiene and dietary habits for the prevention of post-partum non-insulin-dependent diabetes. Obstetrical care can be adapted to risk factors such as overweight, late screening or poor blood glucose control.
Carlotti
N
N
Service de Gynécologie et Service d'Endocrinologie, Hôpital Sud du CHU de Rennes, Bd de Bulgarie, 35000 Rennes.
Moquet
P Y
PY
Foucher
F
F
Laurent
M C
MC
Maugendre
D
D
Grall
J Y
JY
D015992:Body Mass Index; D002585:Cesarean Section; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis; D016640:Diabetes, Gestational / Q000175:diagnosis / Q000628:therapy*; D004420:Dystocia / Q000453:epidemiology; D004704:Endocrinology; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology; D005320:Fetal Macrosomia / Q000453:epidemiology; D018149:Glucose Intolerance; D006748:Hospital Departments; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D009775:Obstetrics and Gynecology Department, Hospital; D010348:Patient Care Team; D011247:Pregnancy; D012189:Retrospective Studies; D012782:Shoulder