Specialised fetal and maternal service: Outcome of pre-gestational diabetes

The objective of the study was to determine the outcome of pregnancies with pre-gestational diabetes mellitus (PGDM) in the presence of a specialised maternal and fetal service. Prospective data included mothers with documented pre-gestational diabetes (PGDM) delivered between 1 January 2007 and 31 December 2009. A total of 138 patients with PGDM were included in this study. The post-lunch glucose level at 34 weeks was significantly lower than at 30 weeks' gestation (p 0.007) and 37 weeks' gestation (p 0.02). No correlation was observed between maternal blood sugar and birth weight. The incidence of pre-term labour, stillbirth and admission to the NICU was similar to the control group. Caesarean section rate was 39.1%, and the main indication was previous caesarean section. The incidence of fetal anomalies was significantly higher than in the control group. It was concluded that the presence of specialised maternal and fetal clinics reduces complications related to prenatal glycaemic control. However, complications related to preconception care remains high.