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This is a shortened version of the eleventh chapter of the ICD-9: Complications of Pregnancy, Childbirth, and the Puerperium. It covers ICD codes 630 to 679 . The full chapter can be found on pages 355 to 378 of Volume 1, which contains all (sub)categories of the ICD-9.
Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy. [2] Gestational diabetes generally results in few symptoms; [2] however, obesity increases the rate of pre-eclampsia, cesarean sections, and embryo macrosomia, as well as gestational diabetes. [2]
Pre-gestational diabetes can be classified as Type 1 or Type 2 depending on the physiological mechanism. Type 1 diabetes mellitus is an autoimmune disorder leading to destruction of insulin-producing cell in the pancreas; type 2 diabetes mellitus is associated with obesity and results from a combination of insulin resistance and insufficient insulin production.
Pre-existing disease in pregnancy, or an acquired disease: A disease and condition not necessarily directly caused by the pregnancy. Diabetes mellitus in pregnancy; Lupus in pregnancy; Thyroid disease in pregnancy; Risks arising from previous pregnancies: Complications experienced during a previous pregnancy are more likely to recur. [64] [65]
Diabetes mellitus and pregnancy deals with the interactions of diabetes mellitus (not restricted to gestational diabetes) and pregnancy. Risks for the child include miscarriage, growth restriction, growth acceleration, fetal obesity (macrosomia), polyhydramnios and birth defects.
Risk factors for pre-eclampsia include obesity, prior hypertension, older age, and diabetes mellitus. [2] [4] It is also more frequent in a woman's first pregnancy and if she is carrying twins. [2] The underlying mechanisms are complex and involve abnormal formation of blood vessels in the placenta amongst other factors. [2]
The complications of diabetes can dramatically impair quality of life and cause long-lasting disability. Overall, complications are far less common and less severe in people with well-controlled blood sugar levels. [3] [4] [5] Some non-modifiable risk factors such as age at diabetes onset, type of diabetes, gender, and genetics may influence risk.
“Gravidity” is an important component of a patient’s reproductive history, as it provides insight into the risk factors that the patient has for pregnancy outcomes, such as risk for gestational diabetes, pre-ecclampsia, spontaneous abortion, preterm birth, fetal growth restriction, and more. [5]