Siri L. Kjos|Ute M. Schaefer-Graf|Smeeta Sardesi|Ruth Peters|Ann Buley|Anny H. Xiang|James D. Bryne|Cher Sutherland|Martin Montoro|Thomas A. Buchanan
A Randomized Controlled Trial Using Glycemic Plus Fetal Ultrasound Parameters Versus Glycemic Parameters to Determine Insulin Therapy in Gestational Diabetes With Fasting Hyperglycemia
University of Southern California|Humboldt-Universität zu Berlin|Charité - Universitätsmedizin Berlin|University of Southern California|University of Southern California|University of Southern California|University of Southern California|University of Southern California|University of Southern California|Good Samaritan Hospital|University of Southern California|University of Southern California|University of Southern California
compare management based maternal glycemic criteria management based relaxed glycemic criteria fetal abdominal circumference ac measurements order select patients insulin treatment gestational diabetes mellitus gdm fasting hyperglycemiain pilot study 98 women fasting plasma glucose fpg concentrations 105120 mgdl randomized standard group received insulin treatment experimental group received insulin ac measured monthly 70th percentile andor venous fpg measurement 120 mgdl power projected detect 250g difference birth weightsgestational ages maternal glycemia ac percentiles similar randomization initiation protocol venous fpg p 0003 capillary blood glucose levels p 0049 significantly lower standard group birth weights 3271 458 vs 3369 461 g frequencies birth weights 90th percentile 63 vs 83 neonatal morbidity 25 vs 25 differ significantly standard experimental groups respectively cesarean delivery rate significantly lower 146 vs 333 p 003 standard group difference explained birth weights experimental group infants women receive insulin lower birth weights infants mothers treated insulin 3180 425 vs 3482 451 g p 003in women gdm fasting hyperglycemia glucose plus fetal ac measurements identified pregnancies low risk macrosomia resulted avoidance insulin therapy 38 patients without increasing rates neonatal morbidity