Shoulder dystocia related fetal neurological injuries: the role of diabetic control

• Authors: Leslie Iffy , Michael Brimacombe , Valeria Varadi , Maya Raghuwanshi , Vijaya Ganesh , Vijaya Raju
• Languages of publication: EN

Abstracts

EN

The study explores the roles of routine prenatal diabetic screening and control in the occurrence of neurological birth injuries associated with shoulder dystocia. The investigation involved retrospective review of 226 medical records that contained information about the antenatal events in cases that resulted in permanent neonatal injuries following arrest of the shoulders at delivery. Close attention was paid to diabetic screening and management of mothers with evidence of glucose intolerance. Analysis of the records revealed that one-third of all women, including those with predisposing factors, received no diabetic screening during pregnancy. The majority of confirmed diabetic patients were not treated adequately. Among babies of diabetic women, birth weights exceeding 4500 g were about 30-fold more frequent than among those with normal glucose tolerance. The data suggest that universal screening and rigid diabetic control, including mothers with borderline glucose tolerance, are effective measures for the prevention of excessive fetal growth and intrapartum complications deriving from it. If ignored, impaired maternal glucose tolerance may become a major predisposing factor for neurological birth injuries. It appears therefore that with routine screening for diabetic predisposition and effective control of gestational diabetes the risk of fetal damage can be reduced substantially.

Keywords

EN

Diabetes; Diabetic screening; Shoulder dystocia; Brachial plexus injury; Erb’s palsy

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2009
• Volume: 4
• Issue: 1
• Pages: 76-83

Dates

published

1 - 3 - 2009

online

11 - 2 - 2009

Contributors

author

Leslie Iffy

• Departments of Obstetrics & Gynecology, University of Medicine and Dentistry of New Jersey, 07103, Newark, New Jersey, USA

author

Michael Brimacombe

• Preventive Medicine, University of Medicine and Dentistry of New Jersey, 07103, Newark, New Jersey, USA

author

Valeria Varadi

• Division of Neonatology, St. Margit Hospital, 1032, Budapest, Hungary

author

Maya Raghuwanshi

• Medicine, University of Medicine and Dentistry of New Jersey, 07103, Newark, New Jersey, USA

author

Vijaya Ganesh

• Departments of Obstetrics & Gynecology, University of Medicine and Dentistry of New Jersey, 07103, Newark, New Jersey, USA

author

Vijaya Raju

• Departments of Obstetrics & Gynecology, University of Medicine and Dentistry of New Jersey, 07103, Newark, New Jersey, USA

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Identifiers

DOI

10.2478/s11536-008-0086-y