Shoulder dystocia related fetal neurological injuries: the role of diabetic control
Author:
Iffy Leslie1, Brimacombe Michael2, Varadi Valeria3, Raghuwanshi Maya4, Ganesh Vijaya1, Raju Vijaya1
Affiliation:
1. 1Departments of Obstetrics & Gynecology, University of Medicine and Dentistry of New Jersey, 07103, Newark, New Jersey, USA 2. 2Preventive Medicine, University of Medicine and Dentistry of New Jersey, 07103, Newark, New Jersey, USA 3. 3Division of Neonatology, St. Margit Hospital, 1032, Budapest, Hungary 4. 4Medicine, University of Medicine and Dentistry of New Jersey, 07103, Newark, New Jersey, USA
Abstract
AbstractThe study explores the roles of routine prenatal diabetic screening and control in the occurrence of neurological birth injuries associated with shoulder dystocia. The investigation involved retrospective review of 226 medical records that contained information about the antenatal events in cases that resulted in permanent neonatal injuries following arrest of the shoulders at delivery. Close attention was paid to diabetic screening and management of mothers with evidence of glucose intolerance. Analysis of the records revealed that one-third of all women, including those with predisposing factors, received no diabetic screening during pregnancy. The majority of confirmed diabetic patients were not treated adequately. Among babies of diabetic women, birth weights exceeding 4500 g were about 30-fold more frequent than among those with normal glucose tolerance. The data suggest that universal screening and rigid diabetic control, including mothers with borderline glucose tolerance, are effective measures for the prevention of excessive fetal growth and intrapartum complications deriving from it. If ignored, impaired maternal glucose tolerance may become a major predisposing factor for neurological birth injuries. It appears therefore that with routine screening for diabetic predisposition and effective control of gestational diabetes the risk of fetal damage can be reduced substantially.
Publisher
Walter de Gruyter GmbH
Reference41 articles.
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