Macrosomia and Birth Trauma in Infants of Diet Treated Gestational Diabetic Women
It is well recognized that untreated gestational diabetes is associated with an excess rate of stillbirths and a high frequency of large for dates (macrosomic) infants. The latter can lead to birth trauma for infants delivered vaginally, or high rates of cesarean sections. Treatment of gestational diabetes should be designed to prevent these complications. Standard treatment has consisted of a well balanced diabetic diet. What is not clear is whether all gestational diabetic women should be automatically treated with insulin. Management by diet alone with good control of blood glucose values has been shown to result in normal perinatal mortality (Gabbe etal., 1977; Adashi etal., 1979). However, perinatal morbidity may remain excessive with just dietary therapy. For example, in Gabbe’s series the incidence of fetal macrosomia in the well controlled diet treated women was 20%.
KeywordsInsulin Therapy Fasting Blood Glucose Gestational Diabetes Maternal Weight Shoulder Dystocia
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