title: Management of labour in pregnancy complicated by diabetes.
abstract: Diabetes mellitus complicates <5% of all pregnancies in Pakistan, but is a major cause of perinatal morbidity and mortality, as well as maternal morbidity. Appropriate glycaemic control is not only important throughout pregnancy but is equally important during the intra-partum period. Increased blood glucose levels 4-6 hours prior to delivery increase the chances of hypoglycaemia in neonates. It is essential to optimize blood glucose levels during the intra-partum period as avoiding maternal hyperglycaemia will prevent foetal hyperglycaemia, and hence reduce the chances of neonatal hypoglycaemia and foetal acidaemia. Infants who develop neonatal hypoglycaemia, have a 2-3.5 times higher risk of developing neuro-developmental impairment on follow-up at 18 months to 7 years of age.
authors.affiliation: Consultant Obstetrician & Gynaecologist, OMI Hospital, Karachi.
authors.forename: Sadiah Ahsan
authors.initials: SA
authors.lastname: Pal
authors.affiliation: Senior Lecturer, Department of Healthcare Education, Liaquat National Hospital, Karachi.
authors.forename: Mariam Iqbal
authors.initials: MI
authors.lastname: Ali
mesh_terms: D001786:Blood Glucose; D002648:Child; D002675:Child, Preschool; D016640:Diabetes, Gestational; D005260:Female; D006801:Humans; D007003:Hypoglycemia; D007223:Infant; D007231:Infant, Newborn; D007743:Labor, Obstetric; D010154:Pakistan; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000628:therapy*; D012307:Risk Factors
chemical_list: D001786:Blood Glucose
keywords: Diabetes, Pregnancy, Labour Management, Gestational Diabetes Mellitus (GDM), Caesarean section, Neonatal hypoglycaemia, neonatal hyperinsulinaemia.