11 - Medical Complication In Pregnancy Diabetes At the...

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Unformatted text preview: Medical Complication In Pregnancy Diabetes At the beginning of the 20th century , diabetic women suffered from infetility, and the rare women achieving pregnancy faced a poor prognosis. Maternal death was a real threat,and perinatal survival a more 40 percent. The availability of insulin since 1922, restored fertility and virtually abolished maternal mortality. At the same time, perinatal survival did not change appreciatably. Since 1949 White Classification was developed, permitted individualized timing and mode of delivery, then perinatal mortality was reduced (nearly equivalent to that observed in normal pregnancies.) I. Classification Type I Diabetes Mellitus ----insulin-dependent----immune-mediated and developed in genetically susceptible persons----concordance rate for diabetes in monozygous twins is less than 50% Type II diabetes ----noninsulin-dependent----no HLA association ----familial occurrence----concordance rate for diabetes in monozygous twins is 100% Gestational Diabetes Mellitus Diabetes is the most common medical complication of pregnancy. Patient can be seperated into those diagnosed during pregnancy It is estimated that 90 percent of all pregnacies complicated by diabetes are due to gestational diabetes Approximately 15 percent of women with gestational diabetes will exibit fasting hyperglycemia Classification during pregnancy Table 1 gives a classification recommended by the American College of Obstetricians and Gynecologists in 1986. class onset Fasting plasma glucose 2-hour postprandial glucose therapy A1 Gestational <105mg/dl <120mg/dl Diet A2...
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11 - Medical Complication In Pregnancy Diabetes At the...

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