Email this article Pregnancy and delivery in a patient with a 40-year history of type 1 diabetes mellitus and antiphospholipid syndrome
- Authors: Kapustin R.V.1, Borovik N.V.1, Musina E.V.1, Arzhanova O.N.1, Yarmolinskaya M.I.1, Alekseyenkova E.N.2, Kovalchuk-Kovalevskaya O.V.1, Petrov Y.A.1
-
Affiliations:
- Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
- Saint Petersburg State University
- Issue: Vol 67, No 6 (2018)
- Pages: 93-99
- Section: Articles
- URL: https://medbiosci.ru/jowd/article/view/10974
- DOI: https://doi.org/10.17816/JOWD67693-99
- ID: 10974
Cite item
Full Text
Abstract
Type 1 diabetes mellitus is a condition associated with an increased risk of adverse perinatal outcomes such as spontaneous abortions, preterm birth, placental insufficiency, congenital malformations, and perinatal mortality. Diabetes mellitus combined with cardiovascular diseases in women during pregnancy often leads to hypertensive disorders and pre-eclampsia. The severity of the microvascular diabetic complications and frequency of hypoglycemic episodes, particularly in early pregnancy, are related to the risk of pre-eclampsia. We report the case of pregnancy and delivery of a live newborn in a 42-year-old woman with type 1 diabetes mellitus, pre-existing hypertension, heritable thrombophilia, and antiphospholipid syndrome. She had a 40-year history of type 1 diabetes mellitus with well-controlled diabetic nephropathy and retinopathy. The woman had been receiving continuous subcutaneous insulin therapy for the last five years, which allowed maintaining an appropriate glycemic control during pregnancy. Multidisciplinary supervision of course of pregnancy was carried out from the pre-gravidity stage until delivery and postpartum. In spite of the severe pre-eclampsia and preterm delivery by cesarean section at 36 weeks, she and newborn could avoid the intensive unit care and discharge from perinatal center without any complications.
Full Text
##article.viewOnOriginalSite##About the authors
Roman V. Kapustin
Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Author for correspondence.
Email: kapustin.roman@gmail.com
MD, PhD, Scientific Secretary
Russian Federation, Saint PetersburgNatalia V. Borovik
Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: borovik1970@yandex.ru
MD, PhD, the Head of the Diabetes Mellitus and Pregnancy Center
Russian Federation, Saint PetersburgEkaterina V. Musina
Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: e.musina@mail.ru
MD, PhD, the Head of the Educational and Methodical Department
Russian Federation, Saint PetersburgOlga N. Arzhanova
Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: arjanova_olga@mail.ru
MD, PhD, DSci (Medicine), Professor, the Head of the Obstetric Department of Pregnancy Pathology I
Russian Federation, Saint PetersburgMaria I. Yarmolinskaya
Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: m.yarmolinskaya@gmail.com
MD, PhD, DSci (Medicine), Professor of the Russian Academy of Sciences, the Head of the Department of Endocrinology of Reproduction, the Head of the Diagnostics and Treatment of Endometriosis Center
Russian Federation, Saint PetersburgElena N. Alekseyenkova
Saint Petersburg State University
Email: ealekseva@gmail.com
MD, Resident Physician, Department of Obstetrics, Gynecology, and Reproductive Sciences, Medical Faculty
Russian Federation, Saint PetersburgOlga V. Kovalchuk-Kovalevskaya
Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: kovkolga@yandex.ru
MD, PhD, Senior Researcher, Department of Physiology and Pathology of Newborns
Russian Federation, Saint PetersburgYury A. Petrov
Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: soundstor@mail.ru
MD, PhD
Russian Federation, Saint PetersburgReferences
- Айламазян Э.К., Абашова Е.И., Аржанова О.Н., Коган И.Ю. Сахарный диабет и репродуктивная система женщины: руководство для врачей. - М.: ГЭОТАР-Медиа, 2017. [Aylamazyan EK, Abashova EI, Arzhanova ON, Kogan IY. Sakharnyy diabet i reproduktivnaya sistema zhenshchiny: rukovodstvo dlya vrachey. Moscow: GEOTAR-Media; 2017. (In Russ.)]
- Persson M, Norman M, Hanson U. Obstetric and perinatal outcomes in type 1 diabetic pregnancies: A large, population-based study. Diabetes Care. 2009;32(11):2005-2009. doi: 10.2337/dc09-0656.
- Боровик Н.В., Потин В.В. Влияние беременности на микрососудистые осложнения сахарного диабета 1-го типа // Журнал акушерства и женских болезней. - 2011. - T. 60. - № 3. - C. 63-68. [Borovik NV, Potin VV. Vliyanie beremennosti na mikrososudistye oslozhneniya sakharnogo diabeta 1 tipa. Journal of obstetrics and women’s diseases. 2011;60(3):63-68. (In Russ.)]
- Howarth C, Gazis A, James D. Associations of Type 1 diabetes mellitus, maternal vascular disease and complications of pregnancy. Diabet Med. 2007;24(11):1229-1234. doi: 10.1111/j.1464-5491.2007.02254.x.
- Тиселько А.В., Боровик Н.В., Потин В.В. Эффективность различных режимов инсулинотерапии у больных с сахарным диабетом 1-го типа во время беременности // Журнал акушерства и женских болезней. - 2013. - T. 62. - № 3. - C. 77-82. [Tisel’ko AV, Borovik NV, Potin VV. Efficacy of the different modes of insulin therapy in pregnant women with type 1 diabetes mellitus. Journal of obstetrics and women’s diseases. 2013;62(3):77-82. (In Russ.)]
Supplementary files
