[Pregnancy and delivery course in patients with gestational diabetes mellitus].

OBJECTIVES: The aim of the study was to assess mother and fetal outcome in gestational diabetic women.

MATERIALS AND METHODS: The study covered 689 patients with gestational diabetes mellitus. All women had been taken care of II Department of Obstetrics and Gynecology Warsaw Medical University in 1997-2001 years. The following parameters were analyzed: the patients ages, past obstetric experience, gestational age of GDM diagnosis, pregnancy complications, delivery course and neonatal outcomes.

RESULTS: Among study group 11.9% patients required insulin to maintain blood glucose concentration in normal range. GDM was mostly (44.1%) diagnosed between 29 and 34 weeks of pregnancy. At the recommended gestational age of screening tests--24-28 weeks--there were detected only 33.4% GDM. The most frequent pregnancy complication was imminent preterm delivery (16.7%). Delivery at term occurred of 89.1% of cases. Percentage of preterm deliveries was 10.9%. Spontaneous vaginal deliveries were the most frequent (72.5%). 23.2% women were delivered by Cesarean section. The most frequent indication of surgical labor were the symptoms of intrauterine fetal asphyxia (35.6%) and cephalo-pelvic disproportion (26.3%). Most of the newborn (83.3%) had normal birth weight between 2500 g and 4000 g. Among infants the most frequent complications were: hyperbilirubinemia (17.3%) and hypoglicemia (15.6%). Intranatal death occurred in 0.1% of cases, whereas neonatal death--0.4%. Congenital defects were found in 4.3% of all offspring. The most frequent congenital malformation was heart defect--1.3% of newborns (almost half of all congenital defects)

CONCLUSIONS: Early diagnosis of gestational diabetes mellitus and specialists obstetric surveillance prevent of pregnancy complications and perinatal mortality, morbidity.