The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians · 2011
Association of vaginal delivery efforts with retinal disease in women with type I diabetes.
СтатьяПоддержка NIH: внешняя программаПоддержка службы здравоохранения СШАНазвание и аннотация: Перевод в очереди
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Feghali Maisa, Khoury Jane C, Shveiky David, Miodovnik Menachem
Аннотация
OBJECTIVE: To determine whether the second stage of labor affects the progression of retinopathy in women with type I diabetes mellitus (DM). RESEARCH AND DESIGN: The study is a secondary analysis of 192 pregnant women with type I DM who participated in an interdisciplinary diabetes in pregnancy intervention program between 1978 and 1993. Evaluation for diabetic retinopathy (DR) was performed each trimester and 6-12 weeks postpartum by the same two ophthalmologists. Women were divided into three groups: (i) elective cesarean delivery (n = 60), (ii) cesarean delivery prior to the second stage of labor (n = 69) and (iii) vaginal or cesarean delivery in the second stage (n = 63). Progression of DR during pregnancy and between pregnancy and postpartum was compared among the groups.
RESULTS: Maternal demographics, glycemic control and pregnancy complications were similar among groups. Progression of retinopathy from early and late pregnancy to postpartum did not differ between the three groups.
CONCLUSION: With close follow-up and good glycemic control, expulsive efforts in the second stage of labor do not affect the progression of retinopathy in women with type I DM. Our data support the premise that pregnant women with type I DM and stable retinopathy should not be denied vaginal delivery, if otherwise not contraindicated.
RESULTS: Maternal demographics, glycemic control and pregnancy complications were similar among groups. Progression of retinopathy from early and late pregnancy to postpartum did not differ between the three groups.
CONCLUSION: With close follow-up and good glycemic control, expulsive efforts in the second stage of labor do not affect the progression of retinopathy in women with type I DM. Our data support the premise that pregnant women with type I DM and stable retinopathy should not be denied vaginal delivery, if otherwise not contraindicated.