PATHOLOGIC FETAL HEART-RATE ASSOCIATED WITH POOR METABOLIC CONTROL IN DIABETIC PREGNANCIES

Abstract

Nonstress fetal heart rate (FHR) recording was used as a primary test to detect fetal distress in 145 pregnant women with insulin-dependent diabetes. Testing was performed every 2nd day beginning with the 32nd wk of pregnancy and daily after the 34th wk until delivery. One hundred eighteen (81.4%) had normal, 9 (6.2%) suspicious and 18 (12.4%) pathologic FHR recordings. Poor metabolic control of diabetes was observed in 25 (17.2%) of the 145 pregnancies during the last trimester of pregnancy. Of these 25 women, 9 (35%) with poor metabolic control had a suspicious or pathologic FHR recording, which was significantly more frequent (P < 0.02) than in women with good metabolic control (18 of 120, 15%). The mean value (.+-. SD) of Hb AIc during the last trimester in diabetic women with pathologic FHR records was 7.63 .+-. 0.87%, which was significantly higher (P < 0.02) than in diabetic women with normal FHR records (6.91 .+-. 0.83%). None of the 145 fetuses monitored diet in utero. No obvious iatrogenic morbidity was caused by early intervention in cases with pathologic FHR recordings.