The clinical management of XXXX in pregnancy complicated by @entity2175 .

@entity1 @entity2175 @entity8455 @entity6 @entity14224 @entity5448 @entity4854 @entity413
OBJECTIVE: @entity1 with @entity2175 ( @entity2175 ) are often first identified and diagnosed with @entity6 during pregnancy. Genetics and @entity4854 play an important role in determining fetal size in @entity2175 pregnancies. The principal objective of the current study is to determine the outcomes and clinical management of @entity4854 in pregnancies complicated by @entity14224 gene ( @entity14224 ) and @entity5448 @entity2175 mutations. STUDY DESIGN: A retrospective chart review of 37 @entity1 with a @entity14224 / @entity5448 mutation was conducted. Data on variables such as birthweight, mode of delivery, and the treatment of @entity4854 were available on 89 pregnancies. RESULTS: The birthweight in unaffected @entity14224 offspring was significantly higher than in the affected @entity14224 offspring (4.8 [4.1-5.2] kg vs  3.2 [3.1-3.7] kg; P  = .01). Seven-point home blood @entity413 monitoring over a 7-day period in each trimester demonstrated higher fasting and postprandial glycemic excursions in the first trimester of @entity14224 pregnancies when compared to @entity5448 pregnancies (fasting 104 [90-115] mg/dL vs 84 [77-88] mg/dL; P  = .01 and postprandial 154 [135-196] mg/dL vs 111 [100-131] mg/dL; P  = .04) despite insulin treatment. There was a higher percentage of miscarriages in the @entity14224 group when compared to the @entity5448 @entity2175 group (33.3% vs 14%; P  = .07), which was similar to the background population. Insulin initiated at an early gestation appeared to lower the incidence of @entity8455 in @entity14224 unaffected offspring. CONCLUSION: @entity4854 in @entity5448 pregnancies is easily managed with current insulin protocols; in contrast, glycemic excursions are difficult to manage in @entity14224 pregnancies. There was an increased percentage of miscarriages in @entity14224 pregnancies highlighting the importance of a diagnosis of @entity14224 - @entity2175 in @entity1 prior to conception and the necessity for preconception care.
