Book of Medical Disorders in Pregnancy - Tintash

women with vascular disease are
awaited, regular ophthalmologic review,
monitor for hypertensive disease, fetal
surveillance, normality, growth, wellbeing
(nst, bps), umbilical artery blood
flow gestational diabetics: initially try to
control with diet rather than insulin;
otherwise, as for established diabetics.
Labor/delivery
Timing: can be delayed until term if
diabetes is well- controlled and
pregnancy uncomplicated, method: will
depend on complications in mother (e.g.
hypertension, ophthalmic) and/or fetus
(e.g. macrosomia, acute fetal
compromise) when cesarean section
more likely), Maintain good perinatal
glucose control Postnatal, Reduced
insulin requirements, Continue capillary
glucose monitoring >- Encourage
breastfeeding: Give contraceptive
advice.
Postnatal:
Reduced insulin requirements continue
capillary glucose monitoring, Encourage
breastfeeding. Give contraceptive
advice.
REFERENCES
1. Harley, J.M.G. and Montgemery,
D.A.D. (1965): Brit Med. J. 1 :14.
2. Hadden, D.R. and Harley, J.M.G.
(1967): J. Obstet. Gynaec. Brit Cwlth:
74:669.
3. Obstetrics and Gynaecology, Elliot E.
Phillipp Josephine Barnes, Michael
Newton 2nd Ed. 1977 William
Heinemann Medical Books Ltd.
4. Advances in Clinical Obstetrics &
Gynaecology, Howard J. Osofasky,
M.D. Ph.D. Vol-I, 1982 Williams &
Wilkins Baltimore/London.
33
5. Pregnancy Metabolism, Diabetes and
the fetus Ciba Foundation Symposium.
1979. Excerpta Medica Amsterdam,
Oxford, New York.
6. Haukkamaa, J. Nilsson, C.G. and
Luukkainen, T. Screening, management
and outcome of pregnancy in diabetic
mothers. Obstet. Gynaecol.
55:596,1980.
7. Senders, H.J. Diabetes, Rapid
Advances, Lingering mysteries. Chem.
Engin. 57:30, 1981.
8. Lemons, J.A. Vargas, P. and Delaney,
J.J. Infant of the diabetic mother.
Review of 225 cases. Obstet. Gynaecol.
57 :187, 1981.
9. Schade, 0.5. and Eation, R.P. Insulin
Delivery - today's system, tomorrow's
prospects. Drug Ther.24:37,1981.
10. Advances in Clinical Obstetrics &
Gynaecology, Howard J. Osofasky,
M.D. Ph.D. Vol-I, 1982 Williams &
Wilkins Baltimore/London.
11. Dornhorst A, Beard RW; Gestational
diabetes: a challenge for the
future.;Diabet Med 1993
Dec;10(10):897-905.[abstract].
12. McLellan JA, Barrow BA, Levy JC, et
al; Prevalence of diabetes mellitus and
impaired glucose tolerance in parents of
women with gestational
diabetes.;Diabetologia 1995
Jun;38(6):693-8.[abstract].
13. Kjos SL, Peters RK, Xiang A, et al;
Hormonal choices after gestational
diabetes. Subsequent pregnancy,
contraception, and hormone
replacement.; Diabetes Care 1998
Aug;21 Suppl 2:B50-7.[abstract].
14. Garcia-Patterson A, Corcoy R, Balsells
M, et al; In pregnancies with gestational
diabetes mellitus and intensive therapy,
perinatal outcome is worse in small-forgestational-age
newborns.;Am J Obstet