Henry Ford Hospital Medical Journal


We reviewed details of 89 pregnancies in diabetic women who were delivered from 1980 through 1982. Data are presented on the obstetrical outcome and the level of diabetic control in patients with White classifications of B through R. Although the mean blood glucose levels of all groups failed to meet the criteria for ideal metabolic control (fasting less than 105 mg/dl, postprandial less than 120 mg/dl), the perinatal mortality rate of 4% compared favorably with reports from other centers. Fifty-six percent of our patients were delivered at 37 weeks gestation or later. The primary Caesarean section rate was 37%, and the overall section rate was 50%. Reasons for high rates of preterm delivery and Caesarean section are analyzed. Management of diabetic pregnancies by a "high risk team" consisting of an obstetrician, diabetologist, dietitian, and neonatologist is described. Modern perinatal management, which strives to maintain maternal euglycemia and accurately monitor fetal well-being and maturity, can virtually eliminate the classic causes of increased perinatal morbidity and mortality in diabetic pregnancies. The challenge for the future is to decrease the incidence of congenital anomalies in the infants of diabetic mothers.