Pre-existing diabetes mellitus in a woman who becomes pregnant. Pregnancy has profound effects on diabetic control and insulin requirements, which are almost doubled, and hypoglycaemia is more common. There is an increased risk of many complication, including fetal macrosomia and shoulder dystocia, and pre-eclampsia is twice as common in diabetic pregnancies. Polyhydramnios and preterm labour are also more common. Even in well-controlled cases, delivery is normally indicated approximately two weeks before the estimated date due to the size of the baby and falling insulin requirements with late gestation, which can affect the uteroplacental flow.
Subjects: Medicine and Health.