SURVEILLANCE OF PREGNANT DIABETICS - COMPARISON BETWEEN OUTPATIENT AND INPATIENT MANAGEMENT

From 1982 to 1993 67 diabetic women attended the University Women's Ho spital obstetric clinic at Wurzburg. These women were separated into t wo groups: group 1 (inpatient group) delivered between 1/82 and 7/87, group 2 (outpatient group) delivered between 8/87 and 4/93. Between 19 82 and 1987 we used extensive inpatient care. But did not so after 198 7. The fetus was monitored by ultrasound scans, cardiotocography, oxyt ocin stress test and doppler measurements. Nearly all patients used ho me blood glucose monitoring. We compared blood glucose levels, mode of delivery and fetal outcome for the two groups. There was no significa nt difference in the average blood glucose levels between the two grou ps. Cesarean section rates (37%) and gestational age at delivery (37 w eeks) were similar in both groups. Fetal macrosomia (birth weight > 40 00 g) occured more frequently in the outpatient group (group 1: 4%, gr oup 2: 25%, P<0.01). This fact did not effect perinatal morbidity. Pos tnatal metabolic disorders did not increase. Fetal anomalies occured l ess frequently in the outpatient group (group 1: 7%, group 2: 2%, P<0. 05).