Affiliation:
1. Altai State Medical University;
Altai Regional Clinical Perinatal Center
2. Altai Regional Clinical Perinatal Center
Abstract
Introduction. Pregestational diabetes mellitus during pregnancy negatively affects the course and outcome of pregnancy, primarily due to the increase in obstetric complications, perinatal morbidity and mortality.Aim. Assessment of obstetric and perinatal complications and the possibility of predicting adverse perinatal outcomes in women with type 1 and type 2 diabetes mellitus.Materials and methods. The study included 132 women. The main group consisted of 79 pregnant women, 41 of them with type 1 diabetes mellitus (group 1A) and 38 with type 2 diabetes mellitus (group 1B) and 53 patients – the control group, whose pregnancy was not accompanied by a violation of the mother’s carbohydrate metabolism.Results. Analysis of the course of pregnancy showed that the complicated course of pregnancy is associated mainly with the presence of placental dysfunction in women with diabetes mellitus, which was detected in 94.9% of cases, in contrast to the control group – 33.3%; p = 0,0001. Polyhydramnios (13.9 ± 1.1%; p = 0.005), diabetic fetopathy (13.9 ± 1.1%; p = 0.005), intrauterine fetal hypoxia requiring maternal assistance was detected in women with diabetes mellitus at 30.4% of cases (p = 0.002). Among the detected cases of cerebral ischemia in newborns born to mothers with type 1 diabetes, 43.5 ± 4.2% of women were prematurely delivered according to indications of fetal distress, and 26.1 ± 3.7% were due to decompensated diabetes in the mother. In women with type 2 diabetes mellitus, delivery according to indications from the fetus among children born with CI – 33.3 ± 3.8 percentage (p = 0.598), cases due to decompensation of the underlying disease and early delivery were not detected (p = 0.001).Conclusions. Thus, complicated pregnancy and adverse perinatal outcomes, despite recent advances in obstetrics and endocrinology, are typical for pregnant women with type 1 and type 2 diabetes mellitus. The management and observation of such patients should be carried out by a multidisciplinary team of specialists specialized in this problem, from the preconception stage to the time of delivery.
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