Diabetes mellitus Liu wei Department of ob gy Ren Ji hospital
Diabetes Mellitus Liu Wei Department of Ob & Gy Ren Ji hospital
General Consideration Diabetes mellitus complicating pregnancy Diabetes mellitus is diagnosed before this pregnancy Gestational diabetes mellitus (GDM) Carbohydrate intolerance of varying degree of severity with onset or first recognition during pregnancy. Incidence 1%0-2%(our country); 1%0-10%(other countries)
General Consideration • Diabetes mellitus complicating pregnancy Diabetes mellitus is diagnosed before this pregnancy • Gestational diabetes mellitus (GDM) Carbohydrate intolerance of varying degree of severity with onset or first recognition during pregnancy. • Incidence 1%-2% (our country); 1%-10% (other countries)
The impact of pregnancy on DM The first half of pregnancy 1. Relative insulin sensitivity: insulin requirementy Morning sickness: hypoglycemia The latter half of pregnancy 1. Increased insulin resistance: placental hormones 2. Intake intrapartum: hypoglycemia 3. Postpartum: placental hormones -hypoglycemia
The impact of pregnancy on DM • The first half of pregnancy 1. Relative insulin sensitivity: insulin requirement↓ 2. Morning sickness: hypoglycemia • The latter half of pregnancy 1. Increased insulin resistance: placental hormones↑ 2. Intake↓intrapartum: hypoglycemia 3. Postpartum: placental hormones↓→hypoglycemia
Effects on mother and fetus Effects on monther 1. Spontaneous abortion 2. Preeclampsia 3. Infection: urinary infection 4. Polyhydramnios(羊水过多) 5. Fetal macrosomia(巨大儿), dystocia(难产) 6. Ketoacidosis(酮症酸中毒)
Effects on mother and fetus • Effects on monther 1. Spontaneous abortion 2. Preeclampsia 3. Infection: urinary infection 4. Polyhydramnios (羊水过多) 5. Fetal macrosomia(巨大儿), dystocia(难产) 6. Ketoacidosis (酮症酸中毒)
Effects on mother and fetus Effects on fetus 1. Fetal macrosomia 2. Fetal growth restriction 3. Premature labor 4. Fetal malformation Effects on infant 1. RDS 2. Hypoglycemia
Effects on mother and fetus • Effects on fetus 1. Fetal macrosomia 2. Fetal growth restriction 3. Premature labor 4. Fetal malformation • Effects on infant 1. RDS 2. Hypoglycemia