Education regarding diabetes management is of utmost importance, especially during pregnancy when there are 2 patients being managed at the same time, a mother and a fetus. The level of education the mother receives affects both patients. The constant reevaluation and change in treatment plans based on those evaluations positively affects the outcomes for each of them. There are a number of complications associated with having uncontrolled diabetes during pregnancy. A diabetes in pregnancy management program can offer education, provide continuous evaluation of management options, decrease hospitalizations for glucose control, and decrease complications associated with uncontrolled diabetes. All programs must have a goal, a benchmark by which to measure themselves. Plans must be formulated using current and acceptable standards of care. Once implemented, there must be ongoing evaluation of outcomes to determine whether goals are being met. With implementation of the appropriate quality tools, programs can learn to formulate their plans, implement them, measure the results, improve outcomes, and sustain themselves.
A procedure has been devised in order to establish a pregnancy in a patient with severe, untreatable tubal infertility who had unsuccessfully undergone tubal reconstructive surgery and repeated in-vitro fertilization procedures. This technique, which involves a volunteer, fertile woman, results from the combination of two infertility treatments: namely gamete intra-Fallopian transfer and uterine flushing. The gametes of the infertile couple were introduced into the distal tube of a synchronized volunteer woman; after 5 days, the embryos, recovered by lavage of the volunteer's uterus, were transferred into the patient's uterus with a resulting pregnancy and delivery.
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