We sought to evaluate the likelihood of recurrent diabetes in women with a prior history of diet-treated (class A(1)) gestational diabetes mellitus (GDM). In a retrospective cohort analysis, nulliparous women diagnosed based upon National Diabetes Data Group criteria with diet-treated GDM who had recurrent diabetes in a subsequent pregnancy were compared with those who did not have recurrent diabetes. The probability of recurrent diabetes was calculated using maternal age at first pregnancy, interpregnancy interval, and body mass index (BMI) during the subsequent pregnancy. Three hundred forty-four nulliparous women with diet-treated GDM had a subsequent delivery in our database. One hundred thirty-seven (40%) had recurrent diabetes. Women with a history of GDM were more likely to have recurrent diabetes if they were heavier (193 versus 173 lbs; P < 0.001; BMI 35.7 versus 32.2; P < 0.001) and waited longer between pregnancies (2.9 versus 2.4 years, P = 0.02). Age, interpregnancy interval, and BMI can be used to predict diabetes recurrence in pregnant women with a history of GDM.

Intramural pregnancies are a rare form of ectopic pregnancy located within the myometrium separate from the endometrial cavity. In an effort to prevent potential complications, diagnosis should be made early when more conservative approaches can be performed to preserve reproductive potential. The diagnosis of ectopic pregnancies can be successfully accomplished through sonography; however, intramural pregnancies may be difficult to diagnose as they can appear similar to other etiologies. We present a unique case of a ruptured intramural pregnancy diagnosed with sonography and pelvic MRI in a patient with tuberous sclerosis. Surgical enucleation of the intramural pregnancy was successfully performed with postoperative resolution of beta hCG levels.

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