Management of pregnancy in women with type 1 diabetes mellitus: Guidelines of the French-Speaking Diabetes Society (Société francophone du diabète [SFD])

Bouché, C.; Caliman, Catherine; Lepercq, J.; Lubin, Vanessa; Rouge, D.; Timsit, José; Vambergue, A.

doi:10.1016/j.diabet.2012.02.010

Cited by 28 publications

(10 citation statements)

References 89 publications

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“…Group 1 included women with one prior CS delivery who were eligible for TOLAC according to French guidelines ( n = 1179). We excluded women for whom ERCD was recommended because of more than one previous CS delivery, prior uterine rupture, prior corporeal uterine section, abnormal placental insertion, transversal presentation of the fetus, body mass index (BMI) >50 kg/m², gestational diabetes with suspected fetal macrosomia and birthweight ≥4250 g, pre‐existing diabetes with suspected fetal macrosomia and birthweight ≥4000 g, suspected fetal macrosomia and birthweight ≥4500 g, bones and neurodegenerative pathologies, and abdominal cerclage. Furthermore, we excluded women with clinical situations that indicated an emergency CS before the onset of labour: placenta abruptio, suspicion of uterine rupture, HELLP syndrome, vaginal bleeding, and fetal abnormal vitality.…”

Section: Methodsmentioning

confidence: 99%

Why women with previous caesarean and eligible for a trial of labour have an elective repeat caesarean delivery? A national study in France

Bartolo

Goffinet

Blondel

et al. 2016

BJOG

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Objective To identify the characteristics of women and maternity units associated with elective repeat caesarean delivery (ERCD) in women eligible for trial of labour after caesarean (TOLAC).Design Cross-sectional study.Setting France.Population and sample Using data from the 2010 French National Perinatal Survey, a representative sample of births in France (n = 14 681 women), we studied two groups of women with prior caesarean section: (i) women eligible for TOLAC according to guidelines (n = 1179) and (ii) a subgroup of these women without any medical characteristics that might indicate ERCD (n = 575).Methods Associations were analysed by multilevel logistic regression.Main outcome measures Adjusted odds ratios.Results Among the 1584 women with a previous caesarean, 1179 (74.4%) were eligible for TOLAC according to guidelines (group 1); 490 (41.6%) had ERCD. Risk of ERCD increased with increasing maternal age and body mass index, pre-existing condition and suspected macrosomia and decreased with previous vaginal deliveries. Among the unit characteristics, private status (aOR = 2.3, 95% CI 1.3-4.1) and low level of care (aOR = 2.5, 95% CI 1.4-4.5]) were independently associated with a higher risk of ERCD after adjustment on patient/pregnancy characteristics. The variability of ERCD rate between hospitals was mainly (78%) explained by the status and level of care, and not (0%) by patient/ pregnancy characteristics. Associations with unit characteristics were similar for group 2.Conclusion For women eligible for TOLAC, the rate of ERCD is high and not in agreement with guidelines. Some characteristics of women are associated with ERCD, but the main determinants are at the unit level, which suggests that non-medical reasons are involved in the decision process.Keywords Caesarean delivery, determinants, previous caesarean, repeat caesarean section, route of delivery.Tweetable abstract Elective repeat caesarean in women eligible for trial of labour mainly depends on maternity unit characteristics.

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Section: Methodsmentioning

confidence: 99%

Why women with previous caesarean and eligible for a trial of labour have an elective repeat caesarean delivery? A national study in France

Bartolo

Goffinet

Blondel

et al. 2016

BJOG

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“…• Pre-pregnancy counseling Adolescent girls with diabetes should be aware of the importance of a planned pregnancy. Poor glycemic control around the time of conception increases the risks of congenital malformations, spontaneous abortion, and fetal death (C) (79)(80)(81)(82)(83)(84). Pre-pregnancy counseling and education well in advance of the possibility of pregnancy is advisable with emphasis on:…”

Section: Sexual Healthmentioning

confidence: 99%

Diabetes in adolescence

et al. 2014

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“…These contribute to extremely labile glucose levels in early pregnancy and progressive insulin resistance with advancing gestation [52]. Despite the increased use of insulin pumps and fast-acting insulin analogues, self-management during pregnancy complicated with type 1 diabetes is still not optimal [53].…”

Section: Closed-loop and Pregnancymentioning

confidence: 99%