[Cardiovascular neuropathy in pregnant women with type 1 diabetes].
OBJECTIVE
Autonomic neuropathy has recently been recognized as a potential risk factor in pregnancy of type 1 diabetics. The aim of the study was to highlight this poorly recognized problem in the obstetric management of diabetic mothers.


METHODS
94 pregnant type 1 diabetics aged 20-35 with a minimum five--year duration of diabetes. A normal population, i.e. 46 age-matched pregnant women without diabetes were evaluated, because there are no normal values for this population. Cardiovascular tests and structured clinical examination were performed on 3 occasions 3 times during pregnancy (once in each trimester). Cardiovascular tests were performed using the ProSciCard system. A full test battery were performed and six basic tests were evaluated. HbA1c was used to assess diabetes control. Diabetic polyneuropathy was clinically assessed by Dyck's staging system.


RESULTS
The incidence of moderate and severe autonomic neuropathy in type-1 diabetic pregnant women was 8.5%. There was no increase in the perinatal morbidity and mortality associated with moderate and severe autonomic neuropathy.


CONCLUSIONS
The presence of moderate to severe symptomatic autonomic neuropathy in patients with type-1 diabetes is not a contraindication for pregnancy. If pregnancy is achieved, the patients should be monitored for the occurrence of pernicious vomiting.
Djelmis
Josip
J
Klinika za zenske bolesti i porode, Medicinski fakultet Sveucilista u Zagrebu, Zagreb, Hrvatska. josip.djelmis@zg.tel.hr
Ivanisević
Marina
M
Reljanović
Miroslav
M
Ilijić
Marcela
M
Bljajić
Danko
D
Tuzović
Lea
L
D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000150:complications / Q000175:diagnosis*; D003922:Diabetes Mellitus, Type 1; D003929:Diabetic Neuropathies / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis*; D011254:Pregnancy in Diabetics