The management of DM during pregnancy should be performed in a tertiary care level, it is the duty of primary care levels early diagnosis, initial management and timely referral. Such management requires an interdisciplinary approach, as it involves pharmacological aspects, educational, nutritional, social, psychological and family. To significantly reduce fetal and maternal mortality, the team should include: an obstetrician, a physician trained in diabetologist or diabetes, a neonatologist, a nurse educator, a nutritionist and a psychologist or social worker. Similarly, the patient and family should take an active part in the treatment, with the motivation and education fundamentals for integration.
Tuesday, November 13, 2012
Management of diabetes mellitus during pregnancy
Differences in maternal-fetal prognosis is necessary to distinguish two types of pregnant women with diabetes: (1)6.1 The diabetic woman who is pregnant (pregestational DM). Within this category there are two groups: Patient without chronic vascular complications: here the good metabolic control allows uncomplicated pregnancy curse. Patients with chronic vascular complications: pregnancy accelerates the development microangiopathic renal and retinal level.6.2 Gestational diabetes mellitus: metabolic disorder here has just set in, the risk of a poor metabolic control rests with the fetus. Reports indicate that when GDM is diagnosed and treated intensively, the risk of stillbirth is not larger than the general obstetric population, equally, that the overall incidence and severity of perinatal conditions is lower.Other factors that determine a maternal-fetal poor prognosis, according Pedersen, are: (1) clinical pyelonephritis chemical acidosis or ketoacidosis Preeclampsia-eclampsiaMalpractice (do not follow the treatment plan or consult belatedly)
The management of DM during pregnancy should be performed in a tertiary care level, it is the duty of primary care levels early diagnosis, initial management and timely referral. Such management requires an interdisciplinary approach, as it involves pharmacological aspects, educational, nutritional, social, psychological and family. To significantly reduce fetal and maternal mortality, the team should include: an obstetrician, a physician trained in diabetologist or diabetes, a neonatologist, a nurse educator, a nutritionist and a psychologist or social worker. Similarly, the patient and family should take an active part in the treatment, with the motivation and education fundamentals for integration.
The management of DM during pregnancy should be performed in a tertiary care level, it is the duty of primary care levels early diagnosis, initial management and timely referral. Such management requires an interdisciplinary approach, as it involves pharmacological aspects, educational, nutritional, social, psychological and family. To significantly reduce fetal and maternal mortality, the team should include: an obstetrician, a physician trained in diabetologist or diabetes, a neonatologist, a nurse educator, a nutritionist and a psychologist or social worker. Similarly, the patient and family should take an active part in the treatment, with the motivation and education fundamentals for integration.