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Chapter-25 Perioperative Management of Pregnant Women with Diabetes

BOOK TITLE: Clinical Guidelines for Management of Diabetes in Pregnancy

Author
1. Rajaram Shalini
2. Priya Bhanu
ISBN
9789352703951
DOI
10.5005/jp/books/18049_26
Edition
1/e
Publishing Year
2018
Pages
8
Author Affiliations
1. University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, shalini.rajaram@labnetworx.com, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, shalini_rajaram@rediffmail.com, Guru Teg Bahadur Hospital and University College of Medical Sciences, New Delhi, India, University College of Medical Sciences and GTB Hospital, Delhi, University College of Medical Sciences and Guru Tegbahadur Hospital, Delhi 110095, India, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India; Asia Oceania Research Organization on Genital Infections and Neoplasia (AOGIN), India, New Delhi, University College of Medical, Sciences and Guru Teg Bahadur Hospital, New Delhi, India, All India Institute of Medical Sciences,
2. University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India
Chapter keywords
Perioperative management, diabetes, pregnancy, glycemic target, insulin therapy, blood sugar level, postpartum management, labor, hyperglycemia, hypoglycemia

Abstract

This chapter focuses on perioperative management of pregnant women with diabetes. Women with DM in labor need strict glycemic control to avoid neonatal hypoglycemia as well as maternal wound infections. Preoperative control of diabetes determines the fluctuation of blood glucose during intrapartum period. The most crucial part of management is to avert perioperative maternal hyperglycemia, prevent neonatal hypoglycemia and fetal academia, and reduce maternal wound infections. During perioperative period adequate blood sugar control is required to meet high energy requirements, without pushing the women toward hypoglycemia. This chapter covers the pathophysiology, perioperative management of diabetes, glycemic targets, insulin therapy in perioperative period, monitoring blood sugar levels, intraoperative management, induction of labor, and postpartum management. Intravenous glucose and insulin infusion is the standard treatment during labor. Requirement of insulin during labor depends on the prior glycemic control.

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