Recent Progress in Perinatal Medicine VI. [antikvár]

Introduction The pregnancy of a diabetic woman stands as high risk for mother and child. Thanks to intensive diabetologic and gynaecologic care, the percentage of perinatal mortality (PNM) of children of diabetic mothers could be reduced to an extraordinarily low value during the last decades. Whilst the PNM-percentage was 40% resp. 50% about 40 years ago, general statistics showed an average value of approx. 9%, increasing in some cases, however, to a value of 16%. More and more the obstetric-diabetologic aim of a standard value below 5% is reached. Survey of patients and medical methods From 1953 to 1985 more than 303 diabetic women delivered children in our hospital. Since about 1970 more and more patients were during their pregnancy under the medical care of colleagues and ambulant wards for diabetes, e. g. 16.5% in diabetic ambulant wards, 52% in gynaecologic ambulant wards. The remaining percentage of pregnant women received medical care only for the delivery of their children. These data were evaluated in accordance with the SPSS-X-program, important data were evaluated based on the Wilcoxon-rank-sum-test or the Chi-quadrat-test. Neither urinary tract infections nor hydrammions stand as significant increase of the mortality rate. This was observed on occasion of a case of metabolic imbalance during pregnancy. Neither profession, nationality, family status nor nicotine abusus influences PNM significantly. "Low social standard", however, with 20.2% resulted in a nearly double mortality rate. Discussion You will learn from this report that during the last 30 years the average values of perinatal mortality were reduced considerably. This results above all from the intensive diabetologic and obstetrical care and furthermore a differentiated insuline therapy. It is important to note, that pregnancies not being under medical care of our ambulant wards, show a significantly higher PNM. This is the reason to advise the patients to frequent diabetologic-gynaecological centres. Besides already known risks, such as blood-sugar level, anamnese affected with inheritary obstetrical diseases, metabolic imbalances it resulted from these investigations that above all retarded children and children with