СOMPLICATIONS OF PREGNANCY IN WOMEN WITH DIABETES MELLITUS AND POSSIBILITIES OF THEIR CORRECTION

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Abstract

Reproductive disorders in women with pre-gestational diabetes mellitus lead not only to poorer fertility, but to complicated course and poor outcomes of pregnancy for mother and fetus. Compared to general population, patients with pre-gestational diabetes mellitus have higher frequencies of ovulation delay, ovarian dysfunction and infertility, and if they become diabetic before their puberty, they have later menarche and earlier menopause. All this is caused by functional disorders of hypothalamic-hypophyseal-adrenal axis and ovarian insufficiency with significant decrease in progesterone levels. Pre-conceptional existence of diabetes mellitus is associated with high probability of menstrual cycle disorders, infertility, and in case of pregnancy – with its complicated course (congenital malformations, miscarriage, fetoplacental insufficiency, pre-eclampsia). The risk of these abnormalities is increased in case of late diabetic complications and poor glucose control. Babies born to diabetic mothers, beyond fetopathy and fetoplacental insufficiency, suffer from long term central nervous system disorders that may lead to problems in social adaptation. 

There are no effective treatments for advanced clinical pre-eclampsia and uncontrolled fetoplacental insufficiency that necessitates the pregnancy to be terminated in the interests of mother or fetus. Due to this, in women with pre-gestational diabetes it is reasonable to implement preventive measures including those aimed at the main components of pathophysiology of a number of obstetric complications. In particular, to correct potential complications of pregnancy in women with diabetes mellitus, administration of active forms of folinic acid and normalization of eicosanoid balance with oral polyunsaturated ω-3 fatty acids is indicated during pregnancy planning and during gestation. 

About the authors

V. M. Gur'eva

Moscow Regional Scientific Research Institute for Obstetrics and Gynecology

Author for correspondence.
Email: helgin99@gmail.com

MD, PhD, Leading Research Fellow, Department of Physiological Obstetrics

Russian Federation

F. F. Burumkulova

Moscow Regional Scientific Research Institute for Obstetrics and Gynecology

Email: fake@neicon.ru

MD, PhD, Senior Research Fellow, Therapeutic Group

Russian Federation

T. S. Budykina

Moscow Regional Scientific Research Institute for Obstetrics and Gynecology

Email: fake@neicon.ru

MD, PhD, Head of Clinical Diagnostic Laboratory

Russian Federation

L. S. Morokhotova

Moscow Regional Scientific Research Institute for Obstetrics and Gynecology

Email: fake@neicon.ru

Postgraduate Student, Department of Physiological Obstetrics

Russian Federation

T. A. Buyvalo

Naro-Fominsk District Hospital No. 1

Email: fake@neicon.ru
Obstetrician/Gynaecologist Russian Federation

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Copyright (c) 2015 Gur'eva V.M., Burumkulova F.F., Budykina T.S., Morokhotova L.S., Buyvalo T.A.

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