A 30-year-old class D diabetic is concerned about pregnancy. She can be assured that which of the following risks is the same for her as for the general population?
- Preeclampsia and eclampsia
- Infection
- Fetal cystic fibrosis
- Postpartum hemorrhage after vaginal delivery
- Hydramnios
Maternal diabetes mellitus can affect a pregnant woman and her fetus in many ways. The development of preeclampsia or eclampsia is about four times as likely as among nondiabetic women. Infection is also more likely not only to occur but to be severe. The incidences of fetal macrosomia or death and of dystocia are increased, and hydramnios is common. The likelihood of postpartum hemorrhage after vaginal delivery and the frequency of cesarean section are both increased in diabetic women. The incidence of fetal genetic disorders such as cystic fibrosis is unaffected by diabetes. • Gestational diabetes—when a mother who does not have diabetes develops a resistance to insulin because of the hormones of pregnancy. • Noninsulin dependent—Class A1 • Insulin dependent—Class A2 • Preexisting diabetes—women who already have insulin dependent diabetes and become pregnant. • Class B—diabetes developed after age 20; have had the disease less than 10 years; no vascular complications Medical and Surgical Complications of Pregnancy Answers 123 • Class C—diabetes developed between ages 10 and 19 or have had the disease for 10 to 19 years; no vascular complications • Class D—diabetes developed before age 10; have had the disease more than 20 years; vascular complications are present • Class F—diabetic women with kidney disease called nephropathy • R—diabetic women with retinopathy (retinal damage) • Class T—diabetic women who have undergone kidney transplant • Class H—diabetic women with coronary artery or other heart disease.