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- W143905366 abstract "While in former times pregnancies of women with diabetes often ended unhappily with either intrauterine death or severe postnatal problems for the child, current improved methods of glucose control and fetal surveillance provide the chance of a healthy baby for this high risk group of pregnant women. Management of pregnancies with diabetes has been solely focused on the achievement of very tight glucose control to avoid the negative consequences of maternal hyperglycemia for the fetus, as there is evidence that the development of diabetic fetopathy is linked to maternal glucose values. This has been clearly demonstrated in pregnancies of women with preexisting diabetes with severe hyperglycemia. While in women with gestational diabetes (GDM) who develop only moderate hyperglycemia due to the decreased insulin sensitivity in pregnancy, maternal glucose values seem to be of limited use to identify pregnancies with risk for the fetus. Thus, strategies had been evaluated to include further parameters to target pregnancies with need for intensive metabolic intervention. The first approach, measurement of fetal insulin in amniotic fluid, has been limited due to the invasiveness of amniocentesis but measurement of the fetal abdominal circumference (AC) has become a widely accepted additional tool to guide pregnancies with GDM. Fetal hyperinsulinism leads to accelerated growth primarily of the subcutaneous fat layer of abdomen; excessive growth is the major problem in diabetic pregnancies. Level Ia evidence from four randomized intervention trials supports that metabolic management including fetal ultrasound measurements reduces somatic growth disturbances in diabetic pregnancies." @default.
- W143905366 created "2016-06-24" @default.
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- W143905366 date "2009-01-01" @default.
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- W143905366 title "Use of Ultrasound in the Metabolic Management of Gestational Diabetes and Preexisting Diabetes Mellitus in Pregnancy" @default.
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- W143905366 doi "https://doi.org/10.1007/978-1-60327-250-6_18" @default.
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