Maternal Characteristics and Complications in Pregnancies Complicated with Diabetes

Öz

Abstract Aim: Pregnancies complicated with diabetes are risky pregnancies with different maternal characteristics and increased maternal complications compared to the normal pregnant group. In this study, it is aimed to determine maternal characteristics and maternal complications in pregnant women with different glucose intolerance or blood glucose levels, and to compare them with the information in the literature and to investigate the effectiveness of our follow-up and treatment protocols. Material and Method: This study is carried out with 223 patients at Ümraniye Training and Research Hospital between May 2009 and March 2010. Group 1 in the study, normal glycemic group; Group 2, group with 1 value higher in 100 g oral glucose tolerance test (OGTT); Group 3, gestational diabetes mellitus (GDM), is the blood sugar regulated group; Group 4, the uncontrolled group diagnosed with GDM and whose blood sugar is not regulated; Group 5 consisted of patients with pregestational diabetes mellitus, with or without regulated blood sugar. Results: Considering the maternal characteristics, it is seen that the age, gravida, parity, body mass index (BMI) of Group 3, Group 4 and Group 5 patients are significantly higher than the patients in Group 1 and Group 2. The rates of preeclampsia, macrosomic baby and preterm birth are significantly higher in groups 4 and 5. In terms of delivery types, normal birth rate is high in Group 1, while cesarean section rates are high in Groups 4 and 5. According to the groups, the cases with a 1st minute apgar score less than 7 are significantly higher in Group 4 and Group 5. Conclusion: It is revealed that different glucose intolerances cause some problems in pregnancy, increase complications, and uncontrolled blood glucose levels increase these problems and complications. In pregestational and gestational periods; In such cases, it should be aimed and ensured that these problems and complications are reduced to the lowest possible level with appropriate diagnosis and treatment approaches.

Anahtar Kelimeler

• gestational diabetes mellitus
• high risk pregnancy
• maternal outcomes

Diyabetle Komplike Olmuş Gebeliklerde Maternal Özellikler ve Komplikasyonlar

Öz

Öz Amaç: Diyabetle komplike olmuş gebelikler normal gebe grubuna göre farklı maternal özellikler ve artmış maternal komplikasyonların olduğu riskli gebeliklerdir. Biz bu çalışmada farklı glukoz intoleransları veya kan glukoz düzeylerine sahip gebelerde maternal özellikleri ve maternal komplikasyonları saptamayı, bunları literatürdeki mevcut bilgilerle kıyaslıyarak takip ve tedavi protokollerimizin etkinliğini araştırmayı amaçladık. Gereç ve Yöntem: Bu çalışma Mayıs 2009 ve Mart 2010 tarihleri arasında Ümraniye Eğitim ve Araştırma Hastanesi’nde 223 hasta ile gerçekleştirildi. Çalışmada Grup 1, normal glisemik grub; Grup 2, 100 gr oral glukoz tolerans testinde (OGTT) 1 değer yüksek grup; Grup 3, gestasyonel diyabetes mellitüs (GDM) olup kan şekeri regüle grup; Grup 4, GDM tanısı alıp kan şekeri regüle olmayan kontrolsüz grup; Grup 5, Pregestasyonel diyabetes mellitüslu, kan şekeri regüle veya regüle olmayan hastalardan oluşmaktaydı. Bulgular: Maternal özelliklere bakıldığında Grup 3, Grup 4 ve Grup 5 hastaların Grup 1 ve Grup 2’de ki hastalara göre yaş, gravida, parite, vücut kitle indeksleri (VKİ)’leri, karşılaştırıldığında anlamlı yüksek olduğu görüldü. Grup 4 ve 5’te preeklampsi, makrozomik bebek, preterm doğum görülme oranları anlamlı derecede yüksekti. Doğum şekilleri açısından normal doğum oranı Grup 1’de yüksekken, sezaryan oranları Grup 4 ve 5’te yüksekti. Gruplara göre Grup 4 ve Grup 5’te 1. Dakika apgar skoru 7’den küçük olgular anlamlı yüksekti. Sonuç: Farklı glukoz intoleranslarının gebelikte bir takım sorunlara yol açtığı, komplikasyonları artırdığı, kontrolsüz kan glukoz düzeylerinin bu sorun ve komplikasyonları daha da artırdığını ortaya koyduk. Pregestasyonel ve gestasyonel dönemlerde; bu tür olgularda, uygun tanı ve tedavi yaklaşımları ile bu sorun ve komplikasyonların mümkün olabilecek en düşük düzeye indirilmesi hedeflenmeli ve sağlanmalıdır.

Anahtar Kelimeler

• gestational diabetes mellitus
• high risk pregnancy
• maternal outcomes

Kaynakça

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