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Diabetes mellitus

Fetal compromise

Fetal compromise in maternal diabetes mellitus is determined by type, duration and underlying maternal complications

In gestational diabetes and in uncomplicated pregestational diabetes (usually <10 years duration) the predominal risk factor is hyperglycemia leading to macrosomia (usually the abdominal circumference is proportionally bigger than the head), polyhydramnios, cardiomegaly and sudden stillbirth

In pregestational diabetes (usually >10 years duration) with renal and vascular complications there is increased risk for fetal growth restriction (FGR) and preeclampsia. However, unlike FGR in impaired placentation the FGR in diabetes may be accompanied by increased than decreased amniotic fluid because of the hyperglycemia