Chapter-18 Fetal Monitoring in Pregnancy with Diabetes

BOOK TITLE: Clinical Guidelines for Management of Diabetes in Pregnancy

1. Saxena Pikee
2. Mishra Archana
Publishing Year
Author Affiliations
1. Lady Hardinge Medical College, New Delhi, India, Lady Hardinge Medical College and SSK Hospital New Delhi, India, Reproductive Biomedicine National Institute of Health and Family Welfare, New Delhi, Lady Hardinge Medical College and Suchitra Kripalani Hospital New Delhi, Lady Hardinge Medical College and Smt Sucheta Kriplani Hospital, New Delhi, India
2. Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India, Vardhman Mahavir Medical, College and Safdarjung Hospital, New Delhi, India
Chapter keywords
Diabetes mellitus, DM, gestational diabetes mellitus, GDM, first trimester pregnancy loss, congenital anomaly, aneuploidy, macrosomia, intrauterine growth restriction, IUGR


Diabetes mellitus is known to complicate 6–9% of all pregnancies worldwide. In India, prevalence of gestational diabetes mellitus (GDM) varies from region to region. Pregnancies complicated with diabetes are at high risk for first trimester pregnancy loss, congenital anomalies, aneuploidy, macrosomia, intrauterine growth restriction (IUGR), preterm delivery (both spontaneous and iatrogenic), premature rupture of membranes, and stillbirth. Neonates suffer birth trauma, hypoglycemia, hypocalcemia, hyperbilirubinemia, polycythemia, and consequences of prematurity and congenital malformations. Congenital anomalies contribute to 50% of prenatal mortality and half of it is due to cardiac abnormalities. In second and third trimester, uncontrolled blood sugars may lead to macrosomia in fetus. Maintaining maternal plasma glucose levels within the euglycemic range in pregestational period and throughout the pregnancy and monitoring of fetus are the two essential elements of management of a diabetic pregnancy.

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