Antepartum fetal surveillance in patients with diabetes

When to start?

David C. Lagrew, Richard A. Pircon, Craig Towers, Wendy Dorchester, Roger K. Freeman

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

OBJECTIVE: Although antepartum fetal well-being testing is an accepted practice in the management of diabetic patients, there are few data suggesting when to start. Our goal was to examine when testing should be started in the pregnant diabetic woman. STUDY DESIGN: Antepartum test results and patient histories were prospectively collected on all diabetic pregnancies from January 1981 through December 1991. The data were retrospectively analyzed for when fetal compromise became evident. Fetal compromise was defined as stillbirth, first positive contraction stress test, or intervention because of an abnormal antepartum fetal test result. RESULT: Six hundred fourteen patients were enrolled in the study. There were three stillbirths, 45 (7.4%) patients had at least one positive contraction stress test, and 71 (11.6%) patients were delivered because of an abnormal fetal test result. Those with early compromise (≤ 34 weeks' gestation) could not be identified solely by diabetic class. The majority of patients (73%) requiring early intervention because of an abnormal test were class R or F diabetic patients with a growth-retarded fetus or were patients who had a concomitant diagnosis of hypertension. CONCLUSIONS: Class R or F diabetic patients or diabetic patients with a growth-retarded fetus or a concomitant diagnosis of hypertension may require testing to be started as early as 26 weeks' gestation. Otherwise, testing may be safely delayed until 32 weeks' gestation.

Original languageEnglish (US)
Pages (from-to)1820-1826
Number of pages7
JournalAmerican Journal of Obstetrics and Gynecology
Volume168
Issue number6 PART 1
DOIs
StatePublished - Jan 1 1993
Externally publishedYes

Fingerprint

Pregnancy
Stillbirth
Exercise Test
Fetus
Hypertension
Practice Management
Growth
Pregnant Women

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology

Cite this

Antepartum fetal surveillance in patients with diabetes : When to start? / Lagrew, David C.; Pircon, Richard A.; Towers, Craig; Dorchester, Wendy; Freeman, Roger K.

In: American Journal of Obstetrics and Gynecology, Vol. 168, No. 6 PART 1, 01.01.1993, p. 1820-1826.

Research output: Contribution to journalArticle

Lagrew, David C. ; Pircon, Richard A. ; Towers, Craig ; Dorchester, Wendy ; Freeman, Roger K. / Antepartum fetal surveillance in patients with diabetes : When to start?. In: American Journal of Obstetrics and Gynecology. 1993 ; Vol. 168, No. 6 PART 1. pp. 1820-1826.
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