medical notes

Apr 18th, 2015
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Medical ComplicationIn PregnancyDiabetesAt the beginning of the 20thcentury , diabetic women sufferedfrom infetility, and the rare womenachieving pregnancy faced a poorprognosis. Maternal death was areal threat,and perinatal survival amore 40 percent.The availability of insulin since 1922,restored fertility and virtuallyabolished maternal mortality.At the same time, perinatal survivaldid not change appreciatably. Since1949 White Classification wasdeveloped, permitted individualizedtiming and mode of delivery, thenperinatal mortality was reduced(nearly equivalent to that observedin normal pregnancies.)I. ClassificationType I Diabetes Mellitus----insulin-dependent----immune-mediated anddeveloped in genetically susceptiblepersons----concordance rate for diabetes inmonozygous twins is less than 50%Type II diabetes----noninsulin-dependent----no HLA association----familial occurrence----concordance rate for diabetes inmonozygous twins is 100%Gestational Diabetes MellitusDiabetes is the most commonmedical complication of pregnancy.Patient can be seperated into thosediagnosed during pregnancyIt is estimated that 90 percent of allpregnacies complicated by diabetesare due to gestational diabetesApproximately 15 percent of womenwith gestational diabetes will exibitfasting hyperglycemiaClassification during pregnancyTable 1 gives a classificationrecommended by the AmericanCollege of Obstetricians andGynecologists in

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