Diabetes in pregnancy. The use of home blood glucose monitoring and intensive monitoring to ensure favourable perinatal outcome.

A combined clinic for pregnant diabetic women was established at Baragwanath Hospital to assess the effects of intensive monitoring of mother and fetus and of good glycaemic control on perinatal outcome. Home blood glucose monitoring was introduced as a method for assessing glycaemic control. Standard methods of maternal and fetal monitoring were used. Sixty-two diabetic pregnancies were evaluated prospectively. Twenty women had diabetes diagnosed for the first time in the current pregnancy and the remaining 42 had established diabetes. All patients followed a diabetic diet, and 95% were treated with insulin. The technique and accurate recording of blood glucose were managed by all patients, and a mean capillary blood glucose of 6.5 mmol/l for the group was achieved. Caesarean section was performed in 52% of cases with a mean period of gestation at the time of delivery for the total study population of 37 weeks. The mean neonatal weight was 3,130 g. The perinatal mortality rate of 64/1,000 was accounted for by 3 stillbirths and 1 early neonatal death. No major congenital anomalies occurred.