FETAL SURVEILLANCE AND TIMING OF DELIVERY IN PREGNANCY COMPLICATED BYDIABETES-MELLITUS

Protocols for antepartum fetal assessment in pregnancies complicated b y diabetes mellitus are an important part of a care program that allow s most of these pregnancies to reach term, ensuring fetal maturation. Maternal assessment of fetal activity serves as an efficient screening test in most surveillance programs. These programs have used primaril y biophysical testing consisting of the nonstress test, cardiac stress test, or biophysical profile. Doppler studies have been investigated as an adjunct for identifying fetal compromise. These studies may prov e most valuable in cases of maternal vascular disease. The success of these protocols continues to be predicated on careful regulation of ma ternal glycemia through aggressive therapy with insulin and diet. Reas suring tests of fetal condition are present in most diabetic women and , therefore, permit fetal maturation to occur prior to delivery.