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Glass H Diabetes and Pregnancy

Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri.

Class H diabetes is defined as the presence of diabetes of any duration associated with ischemic myocardial disease. Because of a lack of experience with the coexistence of myocardial ischemic disease and diabetes during pregnancy, it is difficult to offer patients an accurate prognosis for mother and infant during such a gestation. Previous reports suggest that outcomes in this situation are almost routinely poor. It is likely, however, that there is a subset of patients within the class H diabetic population in whom pregnancy can be successful. Reported are the pregnancies of three such patients. The authors suggest that careful attention to cardiac status and glycemic control contribute to both maternal and fetal well-being. Prepregnancy screening of class H patients for evidence of cardiac dysfunction may allow for the screening of those class H diabetic women who are most likely to achieve successful pregnancy outcome.