[Diabetes mellitus complicating pregnancy].
Of the total 25381 delivered in our Department, in the time from January 1987 to December 1993, 175 (0,69%) were from pregnancies with complicated by diabetes mellitus. 171 of that number ended with healthy babies (172), which is a relatively satisfactory outcome. Only 4 patients lost their babies. They were 3 patients admitted to our programme late in their pregnancy period. Already during their first medical examination the diagnosis was a) nonviable pregnancy in 1 case and b) multiple, congenital defects in the remaining 2 cases. 1 baby was died three days after delivery (congenital heart disease). All patients attended classes of special diabetes mellitus education in the Pathology Ward. Each patient underwent programmed control visits by obstetrician and diabetologist; metabolic therapy reached the level of near normoglycemia. In each case the time of delivery was selected individually. As result of such approach majority of patients gave natural birth. Only in 29 cases (16,6%) caesarean operation was performed. The reason for caesarean operation in 12 of the 29 cases was a previous operation of this kind. In the other 5 cases natural birth was impossible, because of the big foetus. Observation of the newborn babies during their first days of life showed that most of them suffered from the following complications: hypoglycaemia (39,8%), hyperbilirubinemia (25,1%), anaemia (12,9%) and hypocalcaemia (7%). All the babies being in generally good condition were discharged from the hospital on the 5th-10th day together with their mothers. It seems that such good results could obtained owing to special programme, which could by applied also in Regional Gynecological-Obstetrical Ward with help of a local diabetologist.