The incidence of congenital malformations in infants of diabetic mothers is increased 2 to 4 times compared to general population. These malformations are frequently multiple.
Typical congenital malformations reported in diabetic embryopathy:
Teratogenic effect of diabetes occurs during the critical 2 to 6 weeks after conception. The exact cause of the teratogenic effect is not known. Specialized preconceptional and prenatal care with strict glycemic control reduce the likelihood of congenital defects. There is close correlation between the incidence of congenital malformations and glykosylated hemoglobin HbA1c values. If optimal glycemic control is achieved prior conception and maintained during the gestation, the malformation rates decrease similar to those in the healthy population.
This risk is the same for diabetes mellitus of type 1 and 2.
Peroral antidiabetics are contraindicated during pregnancy.
37 — year old woman with type 2 diabetes mellitus, obesity and hypertension. There was no preconceptional and prenatal care. The mother continued on peroral anditiabetics. Second trimestr ultrasonography revealed multiple congenital malformations of the fetus. The aborted fetus was macerated.
Final diagnosis: diabetic embryopathy.
Macerated 17-week male fetus.
It was not possible to examine the brain and kidneys because of severe maceration of the fetus.
Macerated 17-week fetus with phocomelic diabetic embryopathy: Diabetic embryopathy, Macro, autopsy (72753)