TY - JOUR
T1 - Gestational diabetes mellitus - Implications of different treatment protocols
AU - Peled, Yoav
AU - Perri, Tamar
AU - Chen, Rony
AU - Pardo, Joseph
AU - Bar, Jacob
AU - Hod, Moshe
N1 - Funding Information:
This may have been due in part to maternal demand21,22 and to the growing tendency of physicians to 'play it safe' because of the increase in medical malpractice suits. This assumption is supported by several studies. Tussing et al23, in a study of defensive medicine in obstetrics, reviewed 58,441 obstetric deliveries in New York State. The overall Cesarean section rate was found to be 27.6%, out of which 6.6% could be accounted for by fear of malpractice suits. Localio et al.24 surveyed the computerized discharge data linked with physician and hospital malpractice claims records. Their results, like those of Rock25, showed a substantial impact of claims risk on delivery decision and the rate of Cesarean delivery.
PY - 2004
Y1 - 2004
N2 - Objective: To assess the impact of different management approaches to gestational diabetes mellitus (GDM) on perinatal outcome. Patients and Methods: The study group consisted of 2,060 patients with GDM treated in our center from January 1980 through December 1999. Four time periods were defined on the basis of changes in treatment protocols. Perinatal complications were compared between the periods and with normal pregnancy controls. Results: The last two periods (1993-1999) were characterized by lower mean glucose level, lower mean gestational age at delivery, and a decline in macrosomia, shoulder dystocia and perinatal mortality rates, but also by high rates of labor induction and Cesarean delivery. A significant difference was found between the GDM and normal control groups in rates of labor induction (38.6% vs 10.8%, p <0.001) and Cesarean delivery (34% vs 20%, p <0.001) for the last period. Conclusions: Perinatal complications are preventable with good glycemic control and early induction of labor, but at a cost of a higher Cesarean section rate.
AB - Objective: To assess the impact of different management approaches to gestational diabetes mellitus (GDM) on perinatal outcome. Patients and Methods: The study group consisted of 2,060 patients with GDM treated in our center from January 1980 through December 1999. Four time periods were defined on the basis of changes in treatment protocols. Perinatal complications were compared between the periods and with normal pregnancy controls. Results: The last two periods (1993-1999) were characterized by lower mean glucose level, lower mean gestational age at delivery, and a decline in macrosomia, shoulder dystocia and perinatal mortality rates, but also by high rates of labor induction and Cesarean delivery. A significant difference was found between the GDM and normal control groups in rates of labor induction (38.6% vs 10.8%, p <0.001) and Cesarean delivery (34% vs 20%, p <0.001) for the last period. Conclusions: Perinatal complications are preventable with good glycemic control and early induction of labor, but at a cost of a higher Cesarean section rate.
KW - Complications
KW - Gestational diabetes mellitus
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=3242886231&partnerID=8YFLogxK
U2 - 10.1515/JPEM.2004.17.6.847
DO - 10.1515/JPEM.2004.17.6.847
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AN - SCOPUS:3242886231
SN - 0334-018X
VL - 17
SP - 847
EP - 852
JO - Journal of Pediatric Endocrinology and Metabolism
JF - Journal of Pediatric Endocrinology and Metabolism
IS - 6
ER -