Abstract
The outcome of pregnancies in diabetics without complication have improved dramatically, but the maternal and fetal risks in complicated cases such as nephropathy remain high. We report a pregnant insulin-dependent diabetic whose case was complicated by nephropathy associated with pyelonephritis and hypertension, who delivered a 511 g premature infant in the 27th week of gestation.
The 27-years-old woman suffered the onset of diabetes mellitus at 9 years of age and had continuous proteinuria at 25. She also had pyelonephritis and was refred to us in the 16th week of gestation because of hyperglycemia. After admission, she was given the intensified conventional insulin treatment and antibiotic agent upon which her blood glucose level improved to almost normal and inflammation disappeared. The maternal hypertention and renal function progressively worsened and fetal growth retardation was suspected. Signs of fetal distress appeared in the 27th week of gestatin and a Caesarean section was done. After delivery, the maternal blood pressure and renal function were stabilized. The infant is developing well and weighed 1, 600 g at the age of 5 months.
