Amniotic fluid insulin testing in gestational diabetes: safety and acceptance of amniocentesis.

Abstract

We analyzed the safety and patient acceptance of amniotic fluid insulin measurements by third-trimester amniocentesis in women with gestational diabetes mellitus. We studied the rate of early uterine contractions, need for tocolysis, premature rupture of membranes, mode of delivery, length of gestation, and fetal weight and length at birth in 194 women with gestational diabetes mellitus who underwent third-trimester amniocentesis and 268 controls. Patient acceptance of amniocentesis was assessed prospectively with a visual rating scale and a semistructured interview comparing 50 women with gestational diabetes mellitus to 50 women undergoing second-trimester amniocentesis for fetal karyotyping. Only the length of gestation differed significantly but without clinical relevance (39.5 +/- 1.9 vs 40.0 +/- 2.0, P = .006) between women with gestational diabetes mellitus who had amniocentesis and controls. Patient acceptance was equally high both for second-trimester and third-trimester amniocentesis. Third-trimester amniocentesis for measuring amniotic fluid insulin is safe and well accepted by the patients. This is important information both for treating and counseling women with gestational diabetes mellitus.