Programmable Births in Gestational Diabetes Mellitus: Minimizing Risks — Improving Maternal and Perinatal Outcomes

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Abstract

Background. Modernity is characterized by an avalanche-like increase in the frequency of gestational diabetes mellitus (in 4–5 times over the past 20 years). The main tasks of the work in the risk strategy of gestational diabetes mellitus are: prediction of pregnancy complications and the searchingh for new technologies for their delivery. To date, there are still very controversial questions about the timing and methods of delivery of patients with gestational diabetes mellitus. Due to the high incidence of unfavourable perinatal outcomes in gestational diabetes mellitus, the percentage of cesarean sections in some countries reaches 60%, which leads to maternal morbidity and a decrease in the reproductive health of the population. Aims — is to improve of maternal and neonatal outcomes based of the rational choice of delivery technology in gestational diabetes mellitus. Methods. A retrospective analysis of delivery methods was performed in 9769 patients with gestational diabetes mellitus at full-term gestation. Results. The developed and implemented programmed delivery technique was an alternative to cesarean sections, it allowed to reduce the frequency of abdominal delivery, while improving maternal and neonatal outcomes. The frequency of cesarean sections in programmed delivery was 2 times lower than in the presented facilities and significantly lower than in the population (10.0–10.7%). In the programmed delivery group there was a significant reducing morbidity of hypoglycemia in newborns compared to planned caesarean section — by 2 times and respiratory distress syndrome — by 2.5 times (p < 0.05). The indices of cerebral status impairment, birth traumatism corresponded to physiological childbirth and did not exceed the average population. Conclusions. The method of programmed delivery presented in this paper was one of the reserves for reducing the frequency of cesarean sections and allowed to personalize delivery in respiratory distress syndrome.

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About the authors

Nadezhda M. Startseva

RUDN University

Email: n.startseva@yahoo.com
ORCID iD: 0000-0001-5795-2393
SPIN-code: 3415-3773

MD, PhD, Professor

Russian Federation, 6, Miklukho-Maklaya str., 117198, Moscow

Viktor E. Radzinsky

RUDN University

Email: radzinsky@mail.ru
ORCID iD: 0000-0003-4956-0466
SPIN-code: 4507-7510

MD, PhD, Professor

Russian Federation, 6, Miklukho-Maklaya str., 117198, Moscow

Olga V. Papysheva

S.S. Udin City Clinical Hospital

Email: viulen@mail.ru
ORCID iD: 0000-0002-1143-669X

MD, PhD

Russian Federation, Moscow

Larisa N. Esipova

N.E. Bauman City Clinical Hospital No. 29

Email: larisaesipova1@mail.ru
ORCID iD: 0000-0002-1190-238X
Russian Federation, Moscow

Marina A. Oleneva

N.I. Pirogov City Clinical Hospital No. 1, “Maternity house No. 25”

Email: 9161650729@mail.ru
ORCID iD: 0000-0003-2083-7476

MD, PhD

Russian Federation, Moscow

Olga B. Lukanovskaya

N.E. Bauman City Clinical Hospital No. 29

Email: lukanovskaya@gmail.com
ORCID iD: 0000-0003-3865-1290
Russian Federation

Olgа N. Cheporeva

N.I. Pirogov City Clinical Hospital No. 1, “Maternity house No. 25”

Email: tcolga@yandex.ru

MD, PhD

Russian Federation, Moscow

Еvgenij K. Tazhetdinov

N.I. Pirogov City Clinical Hospital No. 1, “Maternity house No. 25”

Author for correspondence.
Email: e_tazhetdinov@mail.ru
ORCID iD: 0000-0002-1918-6031

MD, PhD

Russian Federation, Moscow

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Supplementary files

Supplementary Files
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1. Fig. 1. Dynamics of the number of births and the frequency of cesarean sections in patients with gestational diabetes mellitus, 2009–2019. GDM - gestational diabetes mellitus, CS - caesarean section

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2. Fig. 2. Dynamics of the number of births and the frequency of cesarean sections in general for 2 maternity hospitals, 2014–2019 KS - caesarean section

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3. Fig. 3. Dynamics of the number of programmed births in patients with gestational diabetes mellitus and the frequency of caesarean section, 2014–2019. GDM - gestational diabetes mellitus, CS - caesarean section, PR - programmed labor

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