Complications of diabetes in pregnancy Includes all except
FETAL AND NEONATAL HAZARDS Fetal Macrosomia (40-50%) due to Maternal Hyperglycemia and Elevation of maternal free fatry acids. Congenital malformation(6-10%) Bih injuries are associated with prolonged labour and shoulder dystocia due to macrosomic baby. Growth Restriction is less commonly observed and is associated with maternal vasculopathy. Fetal Death has got multifactorial pathogenesis but the final event being hypoxia and lactic acedemia. Neonatal complications- a) Hypoglycemia (<35mg/dL) is due to Hyperinsulinemia b) Respiratory Distress syndrome due to excess level of fetal insulin that blocks the action of coisol. c) Hyperbilirubinemia d) Polycythemia e) Hypocalcemia(<7mg/dL) f) Hypomagnesemia (<7mg/dL) g) Cardiomyopathy Long term effects- childhood obesity, metabolic syndrome, Neuropsychological effects and diabetes. PERINATAL MOALITY: Overall perinatal moality is increased 2-3times. Reference: DC.Duttas textbook of OBG, 9th edition, page 265 266
Macrosomia
Shoulder dystocia
Hyperglycemia in newborn
lUGR
Medical, surgical and gynaecological illness complicating pregnancy