CHSJ

Curr Health Sci J, vol. 43, no. 4, 2017

Prenatal, Obstetric and Perinatal Aspects in Pregnancy Associated with Pregestational Diabetes

[Case Report]

A.V. TETILEANU(1), C. BERCEANU(2), S. PAITICI(3), L.E. CIUREA(4), S. BERCEANU(2)


(1)Department of Obstetrics and Gynecology, Emergency County Hospital TArgu-Jiu, Romania; Doctoral School, University of Medicine and Pharmacy Craiova, Romania; 
(2)Department of Obstetrics and Gynecology, University of Medicine and Pharmacy Craiova Romania; 2ndObstetrics and Gynecology Clinic, Emergency County Hospital Craiova, Romania; 
(3)2nd Surgery Clinic, Emergency County Hospital Craiova, Romania; Doctoral School, University of Medicine and Pharmacy Craiova, Romania; 
(4)2nd Obstetrics and Gynecology Clinic, Emergency County Hospital Craiova, Romania; Doctoral School, University of Medicine and Pharmacy Craiova, Romania


Abstract:

We report the case of a 37-year old primigesta, primipara (IGIP) patient with a singleton, naturally obtained pregnancy, diagnosed with type I diabetes mellitus from the age of three, carrier of an insulin pump for 11 years. The patient was diagnosed in adolescence with with a tumor of the ischio-rectal fossa with multiple attempts of excision which failed due to the particular situation of the tumor. Ultrasound examination diagnosed in the first trimester of pregnancy a voluminous right ovarian cystic tumor. The patient presented pregnancy-induced hypertension starting with 28 gestational weeks. Maternal-fetal and obstetric management assumed sequential ultrasound examination, ovarian tumor and maternal blood pressure drug control, and also the surgical management of the ischio-rectal tumor. Cesarean section was performed at 38 gestational weeks, outcoming with a live fetus, normal weight, good neonatal progression and favorable postoperative progression of the mother. In this case report, we emphasize the fact that in pregestational diabetes mellitus and pregnancy-induced hypertension, constant glycemic control, performed by the insulin pump, prior and during gestation, and the maternal blood pressure control are essential for maternal-fetal outcome.


Keywords: glycemic control, insulin pump, blood pressure control, ischio-rectal tumor, surgery



Corresponding: C. Berceanu, Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Emergency University Hospital of Craiova, 2 Petru Rares Street, 200349 Craiova, Romania, e-mail: dr_berceanu@yahoo.com


DOI 10.12865/CHSJ.43.04.15 - Download PDF
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