AMNIOTIC-FLUID INSULIN TESTING IN GESTATIONAL DIABETES - SAFETY AND ACCEPTANCE OF AMNIOCENTESIS

OBJECTIVES: We analyzed the safety and patient acceptance of amniotic fluid insulin measurements by third-trimester amniocentesis in women w ith gestational diabetes mellitus. STUDY DESIGN: We studied the rate o f early uterine contractions, need for tocolysis, premature rupture of membranes, mode of delivery, length of gestation, and fetal weight an d length at birth in 194 women with gestational diabetes mellitus who underwent third-trimester amniocentesis and 268 controls. Patient acce ptance of amniocentesis was assessed prospectively with a visual ratin g scale and a semistructured interview comparing 50 women with gestati onal diabetes mellitus to 50 women undergoing second-trimester amnioce ntesis for fetal karyotyping. RESULTS: Only the length of gestation di ffered significantly but without clinical relevance (39.5 +/- 1.9 vs 4 0.0 +/- 2.0, P = .006) between women with gestational diabetes mellitu s who had amniocentesis and controls. Patient acceptance was equally h igh both for second-trimester and third-trimester amniocentesis. CONCL USIONS: Third-trimester amniocentesis for measuring amniotic fluid ins ulin is safe and well accepted by the patients. This is important info rmation both for treating and counseling women with gestational diabet es mellitus.