Diabetes is one of the major health problems in the world today. The number of patients is increasing every day, consequently, more often observed while diabetes and pregnancy. Therefore, the issues of diagnosis and treatment of this disease are aimed at reducing the pathology of the fetus and the elimination of acute complications in women during pregnancy and after delivery.

Clinic diabetes in pregnant women

The clinical manifestations of diabetes in the first place is polyuria (allocation of large amounts of urine, often as much as 10-15 liters per day). This is because the body tries to get rid of the "superfluous" glucose and kidneys to produce more urine volume to remove it. Accordingly, in this background, there is a constant thirst and dry mouth. Since glucose is not absorbed in the body, patients are constantly experiencing hunger Psychology and physiology of hunger - the two sides of the same coin . Itchy skin is the result of stimulation of glucose, which is then excreted. This leads to a tendency of patients to furunculosis and pyorrhea. Also for diabetics characterized by heart palpitations, constant fatigue, blurred vision (retinal vascular lesions) including blindness, tooth decay, insomnia, pain in the heart and calf muscles.

The severity of diabetes is determined based on the level of fasting blood sugar (before treatment):

• mild - blood glucose levels do not exceed 7 and 77 mmol / L, no ketosis, achieved normal blood sugar diet;
• average degree - fasting glucose is 13, 9 mmol / L, no ketosis, normoglycemia is achieved by administration of oral anti-diabetic tablets or insulin;
• severe degree - fasting glucose greater than 13, 9 mmol / L, there is a tendency to ketosis, the compensation of the disease is achieved by insulin injections.

Prenatal care in the antenatal clinic

All pregnant women who have diabetes are a high risk group. For the prevention of diabetic fetopathy taking into account the needs of insulin is recommended hospitalization of women three times during pregnancy. Stages of hospitalization of pregnant women:

• At the first appearance (the first trimester) addressed the issue of the possibility of continuing the pregnancy. To do this, conduct a thorough inspection or correction of insulin.
• In the second half of pregnancy (20-24 weeks) - due to the worsening of the disease and an increase in insulin requirements and to clarify the comorbidity. These terms also conduct prevention of hypoxia in the fetus.
• The term of 32-38 weeks (the most frequent complications). In this period cardiotocography, fetal ultrasound. Also addressed the issue of delivery, made the selection and correction doses of insulin and treatment of possible complications.
• Hospitalization, in addition to the planned, at any stage of pregnancy for reasons (in particular, in the process of decompensation).
• Antenatal hospitalization period of 37-38 weeks.

Contraindications to the preservation of pregnancy in diabetes

In many cases, prolong pregnancy in diabetes Diabetes   You can not:

• insulin-dependent diabetes with the presence of rapidly progressive vascular complications;
• the presence of labile (with a tendency to ketoacidosis), or insulin-resistant forms of diabetes;
• preceded by a long decompensation with hepatodystrophy, inflammatory processes;
• diabetes in both parents (increases the risk of disease in children);
• the combination of diabetes and Rh immunization mother;
• combination of diabetes and tuberculosis;
• a combination of the disease pathology of the cardiovascular system with blood circulation;
• women having children with congenital malformations or diabetic patients.

Treatment of diabetes during pregnancy

Of course, you need to follow a diet. To refuse food rich in carbohydrates (pastries and sweets). Mild diabetes correction helps to normalize the diet. Severe disease is treated with insulin (usually injected).

Anna Sozinova

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