Management of pregnant patients with diabetes with ischemic heart disease

Abstract

Management of pregnant patients with diabetes who have ischemic heart disease (IHD) remains a challenging clinical dilemma for obstetricians and maternal fetal specialist alike. The diagnosis of women with IHD is difficult, primarily because of a lack of awareness of the atypical characteristics at presentation by both patient and provider. Counseling of women regarding pregnancy when they are diabetic with IHD is best done before conception. Management by trimester should focus on careful monitoring of maternal cardiac status and stabilization of glycemic control without hypoglycemia. Delivery and postpartum care remain critical in the avoidance of complications and mortality.