Obstetrical Management of Gestational Diabetes Mellitus.

Kim,  Moon Young

doi:2015.16.3.182

J Korean Diabetes > Volume 16(3); 2015 > Article

Focused Issue

The Journal of Korean Diabetes 2015;16(3):182-188.
DOI: https://doi.org/10.4093/jkd.2015.16.3.182 Published online September 30, 2015.

임신성 당뇨병의 산과 관리

김문영

Obstetrical Management of Gestational Diabetes Mellitus.

Moon Young Kim

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Korea. mykimdr@gmail.com

Abstract

Gestational diabetes mellitus (GDM) is traditionally defined as newly onset or detected carbohydrate intolerance during pregnancy. Unprotected exposure to high glucose levels during pregnancy is related to adverse pregnancy outcomes including fetal demise and intrauterine growth restriction associated with placental insufficiency. The most common complications related to GDM comprise macrosomia, shoulder dystocia, brachial plexus palsy, intrauterine fetal death and preeclampsia, polyhydramnios, preterm delivery, and increased cesarean section rate. Moreover, GDM may increase the chance of GDM recurrence in a subsequent pregnancy, impaired glucose tolerance or type 2 DM, and obesity or impaired glucose tolerance in the offspring. Therefore, proper obstetrical management and glucose control are always challenging and important. The aim of this article is to discern: 1) obstetric complications related to GDM diagnosed after pregnancy, 2) various methods of fetal surveillance, 3) proper timing for delivery and mode of delivery, 4) postpartum management for GDM patients and neonates, and 5) preconceptional counseling prior to a possible subsequent pregnancy.

Key Words: Gestational diabetes, Obstetrics, Preconception, Pregnancy complication