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Chapter-07 Exploring Causes of Stillbirth in Diabetic Pregnancies

BOOK TITLE: Clinical Guidelines for Management of Diabetes in Pregnancy

Author
1. Gujral Kanwal
2. Nayar Sakshi
ISBN
9789352703951
DOI
10.5005/jp/books/18049_8
Edition
1/e
Publishing Year
2018
Pages
6
Author Affiliations
1. Sir Ganga Ram Hospital, New Delhi, India
2. Lady Hardinge Medical College and Smt Sucheta Kriplani Hospital, New Delhi, India
Chapter keywords
Stillbirth, diabetic pregnancy, gestational diabetes mellitus, GDM, perinatal mortality rate, PNMR, maternal hyperglycemia, fetal erythropoietin, fetal cardiac dysfunction, oxidative stress

Abstract

This chapter describes causes of stillbirth in diabetic pregnancies. Global prevalence of pregestational diabetes and gestational diabetes has increased in both high-income and low-income group countries. Both pregestational (type I and II) and gestational diabetes contribute to perinatal mortality rate (PNMR). This chapter covers the maternal hyperglycemia and stillbirth, fetal erythropoietin and stillbirth, fetal cardiac dysfunction and stillbirth, and oxidative stress and stillbirth. Maternal hyperglycemia results in fetal hyperglycemia, which stimulates fetal pancreatic β-cells leading to marked fetal hyperinsulinemia. Oxidative stress either by increased generation of free radicals or by inadequate antioxidant defense can lead to abnormal cardiac remodeling, hypertrophic cardiomyopathy, and fetal death.

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