ICEECE2012 Poster Presentations Diabetes (248 abstracts)
Diabetic nephropathy and retinopathy: complications in pregnancy and labor
Y. Themeli 1, , V. Bajrami 1 , M. Barbullushi 2, , A. Idrizi 2 , K. Zaimi 1 , K. Mustafaraj 1, , J. Lulo 1 , A. Shtylla 3 , J. Gjoshe 4 & E. Peci 6
1DC ‘Ikeda-Euromedica’, Tirana, Albania; 2UHC ‘Mother Teresa’, Tirana, Albania; 3UHC ‘Koco Glozheni’, Tirana, Albania; 4‘Hygeia’ Hospital, Tirana, Albania; 5DC ‘Med.al’, Tirana, Albania; 6American Hospital, Tirana, Albania.
Background: Diabetes microangiopathy is an important negative factor, that affects directly the maternal and neonatal morbidity.
The objective: To determine the risk factors for the morbidity of the mothers and their fetus in patients with diabetic retinopathy and/or nephropathy.
Methods and design: We followed the course of 50 pregnancies in diabetic woman with nephropathy and/or retinopathy and 50 other pregnancies in diabetic woman without severe microangiopathy. We compered the two groups for the diabetic complications and the maternal and neonatal morbidity.
Results: We found a correlation between retinopathy progression and hyperglycaemia during the first trimester (P<0.05). There was an increase in the deterioration of visual acuity up to blindness due to the progression of microangiopathy in cases of proliferative retinopathy. There was a significant increase of the mean diastolic blood pressure and preeclamptic symptoms occurred in of 67% of the cases with severe microangiopathy (P<0.05). Deterioration of the diabetic nephropathy with excessive proteinuria (>10 g/day) and unmanageable hypertension or a progression of the retinopathy led to an earlier delivery in 83% of the patients (P<0.05). A high rate of preterm deliveries (39%) and a frequent occurrence of intrauterine growth retardation’s (13%) characterised the fetal outcome.
Conclusions: All womans diagnosed with diabetes mellitus during childhood or if the course of the disease is between 10 and 15 years, should have periodic ophthalmological evaluations, control of the renal function, contraceptive advice and an improvement of the metabolic situation. In case of a diabetic nephropathy in combination with hypertension the patients shoud be warned against pregnancy.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.
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