Endocrine Abstracts

Introduction

Pre-pregnancy diabetes and gestational diabetes are gestational risk situations. The objective of our study is to evaluate the course of these pregnancies in order to improve their management.

Patients and methods

Descriptive retrospective study, including 175 patients with diabetic pregnancy followed in the department of gynecology and obstetrics of the Ibn Rochd University Hospital in Casablanca between October 2019 and September 2020.

Results

The study included 175 patients with an average age of 28.8 years, 30% had gestational diabetes and 70% had pre-gestational diabetes. The mean pre-gestational BMI was 26.9 kg/m². For gestational diabetes, the mean gestational age of discovery was 21.7 SA, with 71.4% fasting blood glucose levels versus 21.4% for oral glucose tolerance test (OGTT). Concerning pre-gestational diabetes, 24.5% of patients had type 1 diabetes and 43.5% had type 2 diabetes, of which 4.5% had planned their pregnancy. The average HbA1c was 7.9%. For treatment, 75% of the patients were on insulin and 25% were undergoing hygienic and dietary rules. Glycemic control was perfect in 50.4% of patients, 70.3% of whom had pre-gestational diabetes and 29.7% had gestational diabetes. Concerning the obstetrical complications observed pregnancy-related hypertension in 15.5%, pre-eclampsia in 5%, macrosomia in 13%, threat of premature delivery in 4.5%, malformations and hydramnios in 3.5%. Discontinued pregnancies were observed in 2.9% with no significant difference in complications between patients with and without hypertension.

Discussion

The management of diabetic pregnancy remains a challenge, including pregnancy planning, detecting gestational diabetes, and achieving and maintaining glycemic control to prevent complications.