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- W1965628599 abstract "Following review of our approach to the management of pregnant women with diabetes. We noted that the recommendations for maternal and fetal monitoring and timing of delivery were not unified e.g. North American authors suggest twice weekly non-stress CTG, with frequent ultrasounds from 28–32 weeks. By contrast NICE and the Australian Diabetes in Pregnancy Society (ADIPS) were more conservative. In 2008 we adopted a more conservative approach to obstetric monitoring of diabetic women in pregnancy in the 3rd trimester. This consisted of routine fetal heart rate (FHR) monitoring at 36 weeks and Doppler and growth ultrasounds at 28, 32 and 36 weeks gestation. Insulin requiring women with unstable control were delivered by 39 weeks and those with optimal control were delivered at 40 weeks. Women with diet controlled gestational diabetes mellitus (GDM) were delivered by 41 weeks. The latter were followed throughout pregnancy in a routine antenatal clinic with review by obstetricians, diabetes educators, and dieticians. The aim of this review was to examine the outcomes of women managed with this approach during 2008 and 2009. The gestation at delivery was later by 3.5 days for the GDM group (P = 0.0005) with no difference in birth weights. The one perinatal mortality was a fetus terminated at 20 + 6 weeks for trisomy 13. There were fewer caesarean deliveries in those women with diet controlled GDM than in women taking insulin (34% vs. 48% P = 0.005), fewer instrumental deliveries (9 vs. 22 P = 0.028) and fewer admissions to SCN (1 vs. 16 P < 0.001). There were no differences in birth weight, shoulder dystocia, admissions to NICU or 5 minute Apgar scores ⩽ 7. The majority of women in both groups delivered without needing induction of labour (70% and 56%). Our approach in the management of diabetes in pregnancy was associated with good outcomes for a cohort of 390 women managed in our unit over a 2-year period. The majority of women in both groups delivered before the need for induction of labour." @default.
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- W1965628599 date "2010-10-01" @default.
- W1965628599 modified "2023-09-27" @default.
- W1965628599 title "P14.01: Two-year outcomes following the institution of modified ADIPS ultrasound guidelines for diabetes in pregnancy" @default.
- W1965628599 doi "https://doi.org/10.1002/uog.8482" @default.
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