Hypertension and the pregnancy complicated by diabetes
- 61 Downloads
Diabetes is a frequent complication of pregnancy. Type 1 diabetes is associated with an increased incidence of preeclampsia and pregnancy-induced hypertension. When renal dysfunction is present, the incidence of these complications is remarkably increased. White's class, poor glycemic control during the first half of pregnancy, and early blood pressure elevation are also independent risk factors for developing preeclampsia. Whether gestational diabetes increases the background incidence of preeclampsia is still debated. Because therapeutic interventions such as low-dose aspirin and antioxidants have not been shown to be effective, preventive measures rely on tight blood glucose control, as well as adequate blood pressure treatment.
Unable to display preview. Download preview PDF.
References and Recommended Reading
- 1.Conquering Diabetes. A Strategic Plan for the 21st Century. A report of the congressionally established diabetes research working group 1999. NIH publication No. 99- 4398. http://www.niddk.nih.gov/federal/dwg/fr.pdf.Google Scholar
- 2.ACOG Committee on Practice Bulletins: ACOG Practice Bulletin. Clinical Management Guidelines for Obstetrician-Gynecologists. Number 60, March 2005. Pregestational diabetes mellitus. Obstet Gynecol 2005, 105:675–685.Google Scholar
- 3.American Diabetes Association: Gestational diabetes mellitus. Diabetes Care 2004, 27(suppl 1):S88-S90.Google Scholar
- 9.Sibai BM, Caritis S, Hauth J, et al.: Risks of preeclampsia and adverse neonatal outcomes among women with pregestational diabetes mellitus. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. Am J Obstet Gynecol 2000, 182:364–369.PubMedCrossRefGoogle Scholar
- 16.Cousins L: Obstetric complications in diabetic pregnancies. In Diabetes in Women. Adolescence, Pregnancy, and Menopause. Edited by Reece EA, et al. Philadelphia: Lippincott, Williams, & Wilkins; 2004:351–362.Google Scholar
- 36.Vambergue A, Nuttens MC, Goeusse P, et al.: Pregnancy induced hypertension in women with gestational carbohydrate intolerance: the diagest study. Eur J Obstet Gynecol Reprod Biol 2002, 102:31–35. This study compared the incidence of PIH in three groups according to different gestational glucose intolerance. PIH appears to be linked to the level of glucose intolerance during pregnancy, independently of other known factors of hypertension.PubMedCrossRefGoogle Scholar
- 44.CLASP: a randomized trial of low-dose aspirin for the prevention and treatment of pre-eclampsia among 9364 pregnancy women. CLASP Collaborative Low Dose Aspirin Study in Pregnancy Collaborative Group [no authors listed]. Lancet 1994, 343:619–629.Google Scholar
- 47.Poston L, Brilley AL, Kelly FJ, et al.: Vitamin C and vitamin E in pregnant women at risk for pre-eclampsia (VIP trial): randomized placebo-controlled trial. Available online at http://www.thelancet.com. Accessed March 30, 2006.Google Scholar