Журнал беременности и здоровья детей

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Obstetric Management of a Pregnant With Type I Diabetes and Poor Metabolic Control - A Case Report

Carla Duarte, Adriano Soares, Diana Coelho, Cláudia Guerra, Pedro Oliveira, Luísa Sousa and Humberto S Machado

Pregnancy in women with type I diabetes is associated with an increased risk of fetal, neonatal and maternal complications. This increased risk is directly related to the preconception and gestational metabolic control. Poor glycemic control before and throughout pregnancy is associated with adverse outcomes. In preconception period, congenital anomalies and spontaneous abortions occur often. During pregnancy, the mother is at an increased risk for hypoglycemia or diabetic ketoacidosis as well as accelerated retinopathy, renal function deterioration, pregnancy induced hypertension or pre-eclampsia. The fetus is also at increased risk of macrosomia and intrauterine demise. Appropriate diet counseling, a tight glycemic control and early diagnosis and close monitoring of complications can prevent or minimized adverse effects improving pregnancy outcomes. We present a case of a pregnant woman with type I diabetes with poor metabolic control. Clinical optimization and pregnancy monitoring were a challenge for both the pregnant and the health care professionals involved.