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Antenatal management of the diabetic pregnancy 

Antenatal management of the diabetic pregnancy
Antenatal management of the diabetic pregnancy

Eleanor Jarvie

and Scott M Nelson

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date: 24 October 2020

Pre-existing diabetes is associated with an increased risk of miscarriage, congenital abnormalities, intrauterine death, macrosomia, pre-term delivery (spontaneous and iatrogenic), shoulder dystocia, and perinatal morbidity and mortality.

The incidence of congenital anomalies is directly related to maternal glycaemic control.

Optimal detection of deviant fetal growth and macrosomia are by measurement of abdominal circumference.

Shoulder dystocia is more frequent at lower birth weights in pregnancies complicated by maternal diabetes due to increased neonatal fat mass, but predictive models are poor.

Induction of labour at 38 weeks is associated with a reduction in perinatal complications.

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