Maternal complications in diabetic pregnancy.
Pregnant women with diabetes have to manage both the effect of pregnancy on glucose control and its effect on pre-existing diabetic complications. Most women experience hypoglycaemia as a consequence of tightened glycaemic control and this impacts on daily living. Less commonly, diabetic ketoacidosis, a serious metabolic decompensation of diabetic control and a medical emergency, can cause foetal and maternal mortality. Microvascular complications of diabetes include retinopathy and nephropathy. Retinopathy can deteriorate during pregnancy; hence, regular routine examination is required and, if indicated, ophthalmological input. Diabetic nephropathy significantly increases the risk of obstetric complications and impacts on foetal outcomes. Pregnancy outcome is closely related to pre-pregnancy renal function. Diabetic pregnancy is contraindicated if the maternal complications of ischaemic heart disease or diabetic gastropathy are known to be present before pregnancy as there is a significant maternal mortality associated with both of these conditions.
Newcastle Diabetes Centre, Newcastle General Hospital, UK. Gillian.hawthorne@newcastle-pct.nhs.uk
Gillian
G
Hawthorne
D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D016883:Diabetic Ketoacidosis / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D005260:Female; D018589:Gastroparesis / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D016742:Preconception Care; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D011295:Prenatal Care; D012307:Risk Factors