Maternal complications

Abstract

The changes to which the pregnant woman is subjected -physiological adaptation of her different organic systems, hormonal changes in the different trimesters, with the typical insulin resistance of the third trimester- favor the appearance of gestational diabetes mellitus (GDM). Although these occur in all pregnancies, approximately 10% in our country develop this type of condition.

The most prevalent risk factors -obesity, age, family history, history of previous GDM, first trimester fasting blood glucose greater than 85 mg/dl, macrosomia in previous pregnancies, insulin resistance syndromes- condition its appearance.

This hyperglycemic intrauterine environment generates hyperglycemia in the fetus first and hyperinsulinemia secondary to it; this hyperglycemia will be partly responsible for macrosomia, respiratory distress syndrome, and hypoglycemia in the newborn.

For the mother this diagnosis is not free; the risk of pregnancy-induced hypertension, preeclampsia, and eclampsia is markedly increased, as is the presence of hypertriglyceridemia, the increased risk of cesarean section, and preterm delivery. We do not ignore the fact that the increase in the age of pregnant women implies an association with other pathologies, and prior medication should be considered.

In the future, a greater probability of developing DM, obesity, dyslipidemia, hypertension and cardiovascular disease is already described, regardless of the development or not of DM2.

We must also consider that there is a group of patients who start their DM during pregnancy, both type 1 and type 2, or it is detected during pregnancy. The importance of an accurate and adequate diagnosis helps not only early treatment during pregnancy, but also to minimize future risks with appropriate interventions.