ĐÁNH GIÁ KẾT CỤC THAI KỲ Ở THAI PHỤ ĐÁI THÁO ĐƯỜNG ĐƯỢC ĐIỀU TRỊ INSULIN TẠI BỆNH VIỆN PHỤ SẢN THÀNH PHỐ CẦN THƠ NĂM 2021-2023

Abstract

Background: Diabetes during pregnancy is recognized as a major risk factor for increased obstetric complications. Insulin therapy is indicated when medical nutrition therapy fails to achieve glycemic targets, aiming to mitigate risks for both mother and fetus. Objectives: To evaluate pregnancy outcomes in women with diabetes (including pre-gestational and gestational diabetes) treated with insulin at Can Tho Obstetrics and Gynecology Hospital. Materials and methods: A retrospective cross-sectional study was conducted on 137 women with singleton pregnancies diagnosed with diabetes requiring insulin who delivered at Can Tho Obstetrics and Gynecology Hospital from January 2021 to January 2023. Results: The highest proportion of patients was aged >35 years (54.0%). Regarding adverse obstetric history, a history of macrosomia accounted for 27.7%. Optimal glycemic control was achieved in 65.7% of cases. Postpartum insulin use was recorded in 49.6% of participants. Most pregnancies reached a gestational age of ≥37 weeks (67.2%). Spontaneous labor was the primary reason for the end of pregnancy (89.1%). The cesarean section rate was remarkably high (93.4%). The most frequent complication was large-forgestational-age (LGA) fetuses (53.3%). Other maternal and fetal complications included preterm birth (32.8%), stillbirth (4.4%), and polyhydramnios (16.8%). Low Apgar scores <7 at 1 and 5 minutes were recorded in 4.6% and 3.8% of neonates, respectively. Four cases of neonatal hypoglycemia occurred. Conclusions: Insulin-treated diabetes in pregnancy is associated with high obstetric risks. While the majority of patients underwent cesarean delivery and achieved optimal glycemic control by the end of pregnancy (65.7%), the incidences of complications such as preterm birth, LGA (macrosomia), and stillbirth remain high.