MedStar Authors catalog › Details for: 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. Journal: 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.ISSN: 1476-4954.UI/PMID: 21957876.Subject(s): Blood Glucose/an [Analysis] | Cesarean Section | Diabetes Mellitus, Type 1/bl [Blood] | *Diabetes Mellitus, Type 1/co [Complications] | Diabetes Mellitus, Type 1/th [Therapy] | *Diabetic Retinopathy/pp [Physiopathology] | Female | Humans | Labor Stage, Second/ph [Physiology] | *Labor, Obstetric/ph [Physiology] | Pregnancy | *Pregnancy in Diabetics/pp [Physiopathology] | Retinal Hemorrhage/et [Etiology] | Valsalva Maneuver/ph [Physiology] | Vitreous Hemorrhage/et [Etiology]Institution(s): MedStar Washington Hospital Center | MedStar Health Research InstituteDepartment(s): Obstetrics and Gynecology/Maternal-Fetal MedicineActivity type: Journal Article.Medline article type(s): Journal Article | Research Support, N.I.H., Extramural | Research Support, U.S. Gov't, P.H.SDigital Object Identifier: http://dx.doi.org/10.3109/14767058.2012.626924 (Click here) Abbreviated citation: J Matern Fetal Neonatal Med. 25(1):27-31, 2012 Jan.Local Holdings: Available online through MWHC library: 2013 to the present.Abstract: 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.Abstract: 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.Abstract: 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.