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 Release 22.0, Sept. 2008
 
Chapter : ch15. Obstetics & Gynecology Section : Maternal Assessment During Pregnancy
  Poor Prognostic Findings in Diabetic Women During Pregnancy

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Overview :

Diabetes during pregnancy may be associated with morbidity and mortality for the fetus and mother. Certain findings may indicate a high risk for complications and warrant more aggressive management.

 

Factors of Pedersen and Molsted-Pedersen:

(1) "late enrollers" (no prenatal care)

(2) "neglectors" (no modification of lifestyle for pregnancy, with poor diabetic control)

(3) toxemia

(4) febrile pyelonephritis

 

White's diabetic classes associated with risk to the fetus:

(1) nephropathy with hypertension (F)

(2) cardiopathy (H)

(3) vasculopathy with calcifications in major arteries of pelvis and lower extremity (E, D4)

 

Other:

(1) extremely brittle diabetes (may be managed with use of an insulin pump)

(2) severe ketoacidosis

 

  References:

Evans AT, deVeciana M, Benbarka MM. Chapter 9: Endocrine disorders. pages 121-151. IN: Niswander KR, Evans AT. Manual of Obstetrics, Fifth Edition. Little, Brown and Company, 1996.

Pedersen J, Molsted-Pedersen J. Prognosis and outcome of pregnancy in diabetes. Acta Endocrinol. 1965; 50: 70

Pedersen J. The Pregnant Diabetic and Her Newborn, Second Edition. Williams & Wilkins Company. 1977. page 202-203.

White P. Classification of obstetric diabetes. Am J Obstet Gynecol. 1978; 130: 228-230.

 

 

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