14 2 January 1965 Management of Pregnancy Complicated by Diabetes

In 1956 Stevenson published the results of 119 diabetic pregnancies treated in the Royal Maternity Hospital, Belfast, during the 16-year period 1940 to 1955. As a result of his findings he concluded that some improvement in the foetal mortality should be possible and recommended (1) that there should be the closest co-operation between obstetrician, physician, and paediatrician; (2) strict antenatal care from the beginning of pregnancy; (3) admission to hospital at the twenty-eighth week, or earlier if stabilization is unsatisfactory; (4) premature delivery at 35 weeks, or earlier if indicated; (5) delivery by caesarean section in all primigravidae and all but a very few multigravidae; and (6) skilled nursing of the neonate in a modern nursery unit. For the past eight years the management of diabetic pregnancies in the Royal Maternity Hospital, Belfast, has been influenced to some extent by these recommendations. Consequently it was decided to carry out a further review to see if there had been any improvement in the foetal mortality and whether or not any alterations were necessary in our present management.