Outcome of Pregnancy in Class A1 and A2 Gestational Diabetic Patients Delivered Beyond 40 Weeks' Gestation

Abstract

The charts of all diabetic women and their infants delivered during the years 1983-1988 in our department were reviewed. The test group included consecutive gestational diabetic women class A1 (n = 65) and class A2 (n = 59), who delivered beyond 40 weeks of gestation. The mean gestational age at delivery was 40.90 weeks (range, 40.0 to 42.57) in class A1 and 40.49 weeks (range, 40.0 to 42.28) in class A2 patients. The first control group matched for age, parity, and presentation included 65 gestational diabetic patients class A1 and 59 A2 who delivered prior to 40 weeks' gestation. The second control group matched for age, parity, and presentation included 124 nondiabetic patients who delivered beyond 40 weeks of gestation (mean, 41.04 +/- 0.83 weeks). By allowing the pregnancies of gestational diabetic patients class A1 and class A2 to proceed beyond 40 weeks of gestation, we did not increase the incidence of perinatal mortality and morbidity rate. The cesarean section rate was low (10.76% in class A1 and 22.03% in class A2). We suggest that not only elective intervention prior to 40 weeks of gestation is to be avoided, but an attempt should be made to allow the gestational diabetics class A1 and class A2 to proceed to spontaneous labor.

The association between glucose challenge test, obesity and pregnancy outcome in 6390 non-diabetic women

“…GDM subjects were excluded from the study. Women with a prepregnancy body mass index (BMI: weight in kilograms divided by the square of the height in meters) of 27.3 or more were considered obese [17][18][19]. Total pregnancy weight gain was based on the prepregnancy weight and the last weight measured within a week before delivery.…”

Active Compared With Expectant Delivery Management in Women With Gestational Diabetes

“…1). [11][12][13][14][15] One randomized controlled trial (RCT) compared the effect of two labor-induction protocols on maternal and perinatal outcomes. 11 Four observational studies examined the effect of estimated fetal weight and/or gestational age on delivery management and outcomes.…”

“…11 Four observational studies examined the effect of estimated fetal weight and/or gestational age on delivery management and outcomes. [12][13][14][15] These five studies formed the basis for the current review (Table 1).…”

Besonderheiten der Insulintherapie bei Gestationsdiabetes (GDM) - Special Aspects of Insulin Therapy in Pregnancies Complicated by Gestational Diabetes Mellitus (GDM) -

“…Dieser Anteil erstreckt sich von weniger als 30 % [2,14,32,37,44,53,111,118,123] über 30 ± 50% [14,17,32,35,62,69,107,108,123] und sogar auf 50 ± 100 % der Fälle [4,17,29,54,69,70,74,76,88].…”