THE USE OF ULTRASOUND IN PREDICTION OF FETAL COMPLICATIONS AMONG DIABETIC PATIENTS IN LATE PREGNANCY

Abstract

Diabetes concurrent with pregnancy is a high-risk condition associated with risks for adverse pregnancy outcomes. These risks were unacceptably high and a policy of late preterm delivery induction was the rule. With the advent of improved glycemic management and the introduction of antenatal fetal testing and surveillance, the perinatal risks have dropped significantly such that a healthy pregnancy is expected. Diabetic pregnancies have risk of developing maternal complications like hypertension, pre-eclampsia, polyhydramnios and post-partum hemorrhage and also fetal complications like intrauterine growth restriction, macrosomia, stillbirth and respiratory distress syndrome. The delivery of a macrosomic infant has potentially severe consequences for both the newborn and the mother. Maternity care professionals continue to search for accurate methods of predicting fetal weight in an effort to ameliorate the adverse outcomes that are associated with traumatic delivery. The clinician's intention in anticipating macrosomia is not only to employ cut-offs of estimated fetal weight for selecting cases in which the risk of birth trauma is high enough to warrant delivery by cesarean section, but also to adapt the usual intrapartum management and to plan for induction of labour, at least in diabetic pregnancies.