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Maternal and Fetal Outcomes in Women with Diabetes in Pregnancy Treated before and after the Introduction of a Standardized Multidisciplinary Management Protocol.
- Source :
-
Journal of diabetes research [J Diabetes Res] 2021 Nov 12; Vol. 2021, pp. 9959606. Date of Electronic Publication: 2021 Nov 12 (Print Publication: 2021). - Publication Year :
- 2021
-
Abstract
- Background: Diabetes in pregnancy is associated with an increased risk to the woman and to the developing fetus. Currently, there is no consensus on the optimal management strategies for the follow-up and the timing of delivery of pregnancies affected by gestational and pregestational diabetes, with different international guidelines suggesting different management options.<br />Materials and Methods: We conducted a retrospective cohort study from January 2017 to January 2021, to compare maternal and neonatal outcomes of pregnancies complicated by gestational and pregestational diabetes, followed-up and delivered in a third level referral center before and after the introduction of a standardized multidisciplinary management protocol including diagnostic, screening, and management criteria.<br />Results: Of the 131 women included, 55 were managed before the introduction of the multidisciplinary management protocol and included in group 1 (preprotocol), while 76 were managed according to the newly introduced multidisciplinary protocol and included in group 2 (after protocol). We observed an increase in the rates of vaginal delivery, rising from 32.7% to 64.5% (<0.001), and the rate of successful induction of labor improved from 28.6% to 86.2% ( P < 0.001). No differences were found in neonatal outcomes, and the only significant difference was demonstrated for the rates of fetal macrosomia (20% versus 5.3%, P : 0.012). Therefore, the improvements observed in the maternal outcomes did not impact negatively on fetal and neonatal outcomes.<br />Conclusion: The introduction of a standardized multidisciplinary management protocol led to an improvement in the rates of vaginal delivery and in the rate of successful induction of labor in our center. A strong cooperation between obstetricians, diabetologists, and neonatologists is crucial to obtain a successful outcome in women with diabetes in pregnancy.<br />Competing Interests: All the authors declare no conflicts of interest.<br /> (Copyright © 2021 Maddalena Morlando et al.)
- Subjects :
- Adult
Cooperative Behavior
Diabetes, Gestational diagnosis
Endocrinologists standards
Female
Fetal Macrosomia etiology
Humans
Interdisciplinary Communication
Labor, Induced
Neonatologists standards
Obstetrics standards
Pregnancy
Pregnancy Outcome
Pregnancy in Diabetics diagnosis
Retrospective Studies
Time Factors
Treatment Outcome
Clinical Protocols standards
Delivery, Obstetric adverse effects
Diabetes, Gestational therapy
Patient Care Team standards
Pregnancy in Diabetics therapy
Subjects
Details
- Language :
- English
- ISSN :
- 2314-6753
- Volume :
- 2021
- Database :
- MEDLINE
- Journal :
- Journal of diabetes research
- Publication Type :
- Academic Journal
- Accession number :
- 34805415
- Full Text :
- https://doi.org/10.1155/2021/9959606