Association of vaginal delivery efforts with retinal disease in women with type I diabetes.
Association of vaginal delivery efforts with retinal disease in women with type I diabetes.
Available online through MWHC library: 2013 to the present
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. 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.
English
1476-4954
*Diabetes Mellitus, Type 1/co [Complications]
*Diabetic Retinopathy/pp [Physiopathology]
*Labor, Obstetric/ph [Physiology]
*Pregnancy in Diabetics/pp [Physiopathology]
Blood Glucose/an [Analysis]
Cesarean Section
Diabetes Mellitus, Type 1/bl [Blood]
Diabetes Mellitus, Type 1/th [Therapy]
Female
Humans
Labor Stage, Second/ph [Physiology]
Pregnancy
Retinal Hemorrhage/et [Etiology]
Valsalva Maneuver/ph [Physiology]
Vitreous Hemorrhage/et [Etiology]
MedStar Health Research Institute
MedStar Washington Hospital Center
Obstetrics and Gynecology/Maternal-Fetal Medicine
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.
Available online through MWHC library: 2013 to the present
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. 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.
English
1476-4954
*Diabetes Mellitus, Type 1/co [Complications]
*Diabetic Retinopathy/pp [Physiopathology]
*Labor, Obstetric/ph [Physiology]
*Pregnancy in Diabetics/pp [Physiopathology]
Blood Glucose/an [Analysis]
Cesarean Section
Diabetes Mellitus, Type 1/bl [Blood]
Diabetes Mellitus, Type 1/th [Therapy]
Female
Humans
Labor Stage, Second/ph [Physiology]
Pregnancy
Retinal Hemorrhage/et [Etiology]
Valsalva Maneuver/ph [Physiology]
Vitreous Hemorrhage/et [Etiology]
MedStar Health Research Institute
MedStar Washington Hospital Center
Obstetrics and Gynecology/Maternal-Fetal Medicine
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.