A study of 300 pregnancies in 156 Irish diabetics is presented. Thirty per cent of the pregnancies were fifth or later, and the mean maternal age was thirty years. The abortion rate was 11 per cent, and the loss of viable infants was 10 per cent. There was no maternal death.
Control of diabetes was strict, and this is reflected in the occurrence of hypoglycemic coma on twenty-one occasions. Diabetic ketosis occurred in twelve cases—all of whom were unbooked emergency admissions. The influence of these complications on fetal survival is contrasted.
Pre-eclamptic toxemia and hydramnios in the mother, and respiratory-distress syndrome in the infant contributed heavily to infant loss.
Of recent years the aim has been to deliver at thirtyeight weeks in uncomplicated cases—usually by the vaginal route. The cesarean section rate for the whole series was 22 per cent, and for primigravidae was 29 per cent. A plea is made for a more dynamic approach to vaginal delivery.
