Endocrine Abstracts

Introduction: Pregnancy in diabetics is one of the most frequent forms of high-risk pregnancy. It requires diabetic-obstetric-neonatalogical collaboration. Its risks affect the fetomaternal prognosis in the short and long term. Materials and methods: The aim of our work is to establish the main difficulties in the management of diabetic pregnancy. This is a retrospective study of 100 pregnant diabetic patients followed at the maternity hospital of CHU IBN ROCHD of CASABLANCA, for a period of 2 years. Results: The average age of the patients was 32 years. In 40% of the cases, it was a type I diabetes and 49% a type II diabetes. Gestational diabetes, on the other hand, represented only 11%. Gestational age at the time of the first consultation is on average 2 months, the monitoring rhythm is one consultation per month. Self-monitoring of blood glucose is performed in only 19% of cases. Diabetic pregnancy was complicated by foetal death in 14% of cases, macrosomia in 15% of cases, urinary or genital infection in 17% of cases, spontaneous abortion in 6% of cases and pregnancy toxemia in 1% of cases.

Discussion: The prognosis of pregnancy in diabetic women has improved considerably over the last few years in developed countries, thanks to better management, based on the planning of the pregnancy, justifying the use of reliable contraception, perfect glycaemic control even before conception, rigorous obstetrical, diabetic and neonatal monitoring, and the active participation of the patient. In the light of our study and its comparison with some data in the literature, we feel it is appropriate to emphasise a number of points: The importance of preconception management, in order to optimise glycaemic control before pregnancy, based on education and the implementation of insulin therapy techniques. Good management also requires the motivation of the diabetic woman who must collaborate with a multidisciplinary team. Facilitating access to material means for control and treatment is essential.

Conclusion: Diabetic pregnancy is a high-risk pregnancy for the mother and the foetus. Good medical surveillance by a multidisciplinary team from the preconceptional period until delivery allows a significant reduction in fetomaternal complications. Patient education and information are an integral part of the management of diabetic pregnancy.