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Year 2020 - Volume 30 - Issue 1

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Guideline on Pregnancy and Diabetes by the Society of Specialists in Perinatology (PUDER), Turkey
Received: 17 Feb 2020 | Accepted: 18 Feb 2020 | Available online: 20 Feb 2020
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Merih BAYRAMa, Aydan ASYALI BİRİb, Esra ESİM BÜYÜKBAYRAKc, Halil Korkut DAĞLARd, Fedi ERCANe, Selen GÜRSOY ERZİNCANf, Aytül ÇORBACIOĞLU ESMERg, Cihan İNANh, Hakan KANITı, Özgür KARAi, Doruk Cevdi KATLANj, Tuncay NASa, Ece ÖCALk, Nevin SAĞSÖZl, Cem Yaşar SANHALm, Güler ŞAHİNn, Hakan TİMURd, Uğur TURHANo, Gülenay GENÇOSMANOĞLU TÜRKMENö, Gürcan TÜRKYILMAZp, Filiz Fatma BİLGİN YANIKn, Mehmet Aytaç YÜKSELr
aGazi University Faculty of Medicine, Department of Gynecology and Obstetrics, Section of Perinatology, Ankara, TURKEY
bYüksek İhtisas University, Private Ankara Koru Hospital, Department of Gynecology and Obstetrics, Ankara, TURKEY
cMarmara Üniversitesi Faculty of Medicine, Department of Gynecology and Obstetrics, İstanbul, TURKEY
dAnkara Dr. Zekai Tahir Burak Women's Health Training and Research Hospital, Clinic of Gynecology and Obstetrics, Ankara, TURKEY
eKonya Necmettin Erbakan University Meram Faculty of Medicine, Department of Gynecology and Obstetrics, Konya, TURKEY
fTrabzon Kanuni Training and Research Hospital, Clinic of Gynecology and Obstetrics, Trabzon, TURKEY
gİstanbul Kanuni Sultan Süleyman Health Practice and Research Center İstanbul, TURKEY
hTrakya University Faculty of Medicine, Department of Gynecology and Obstetrics, Edirne, TURKEY
ıPrivate Physician, İzmir, TURKEY
iHatay State Hospital, Clinic of Gynecology and Obstetrics, Hatay, TURKEY
jİstanbul Training and Research Hospital, Clinic of Gynecology and Obstetrics, İstanbul, TURKEY
kManisa Celal Bayar University Faculty of Medicine, Department of Gynecology and Obstetrics, Manisa, TURKEY
lKırıkkale University Faculty of Medicine, Department of Gynecology and Obstetrics, Kırıkkale, TURKEY
mAkdeniz University Faculty of Medicine, Department of Gynecology and Obstetrics, Division of Perinatology, Antalya, TURKEY
nPrivate Physician,, Ankara, TURKEY
oİnönü University Faculty of Medicine, Department of Gynecology and Obstetrics, Division of Perinatology, Malatya, TURKEY
öDr. Sami Ulus Women's and Children's Health Training and Research Hospital, Clinic of Gynecology and Obstetrics, Ankara, TURKEY
pİstanbul University İstanbul Faculty of Medicine, Department of Gynecology and Obstetrics, İstanbul, TURKEY
rŞanlıurfa Women's Health Hospital, Clinic of Gynecology and Obstetrics, Şanlıurfa, TÜRKİYE
J Clin Obstet Gynecol. 2020;30(1):35-42
DOI: 10.5336/jcog.2020-74356
Article Language: EN
Copyright Ⓒ 2024 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
 Diabetes mellitus (DM) is the most common endocrinologic problem in pregnancy. In Turkey, the reported prevalance is between 1.9-27.9%, with an average of 7.7%. While some of these cases are pregestational diabetes (PGDM), about 90% are detected during the pregnancy for the first time and diagnosed as gestational diabetes (GDM). Diabetes in pregnancy confers serious risks regarding the fetus, newborn and the mother. Therefore, we offer GDM screening for all pregnant women preferantially between 24-28 weeks of gestation. Either one-step 75-g oral glucose tolerance test (OGTT) or two-step 50-g glucose challenge test and 100-g OGTT may be used for the screening and diagnosis. In pregnancies with high-risk for DM, screening should be performed earlier, if possible, in the first antenatal visit. When GDM is diagnosed, maternal glycemic control is tried to be achieved by diet and exercise program, and if necessary, by using insulin. The use of metformin or glyburide in pregnancy is also possible. In women with the diagnosis of DM before pregnancy, preconceptional control of plasma glucose levels is of utmost importance in order to prevent adverse pregnancy outcomes. In pregnancies with GDM regulated by diet and exercise, pregnancy follow-up may be performed as in the low risk group without any pregnancy complications. If maternal or fetal distress is not observed, delivery is planned between 39+0 -40+6 weeks. Although caesarean section is recommended when estimated fetal weight is 4500 g or more, the mode of delivery may be decided more appropriately on a case-by-case basis.
KEYWORDS: Pregnancy; diabetes, gestational; diabetes mellitus
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