In managing pregnant diabetics it is notoriously easy to be
deceived by a run of successes. Nevertheless, other centres
too are getting better results than previously, and we think
therefore that we are seeing a real improvement. We assume
that the reasons for this improvement are (1) scrupulous control
of the diabetes (2) careful timing of delivery and (3) intensive
care of the baby during and after labour.
Nevertheless we do not know why the respiratory distress
syndrome is now so much less common than it was a few
years ago. Modem techniques of monitoring before and during
labour are a great advance but we suspect that having a
special team for pregnant diabetics of physicians, obstetricians,
and paediatricians and ancillary staff is even more important.