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Endocrinology


Answer 2
  1. Close follow-up with frequent fundoscopic examinations throughout the pregnancy. Women with diabetes should be screened for retinopathy during the first trimester and then every 3 months thereafter while pregnant. Even in patients with no history of retinopathy prior to pregnancy, retinopathy can develop progressively throughout pregnancy. Nonproliferative diabetic retinopathy produces increased capillary permeability, microaneurysms, hemorrhages, and exudates. It can be treated with focal laser therapy when clinically significant macular edema develops. Both laser therapy and vitreous surgery can be performed safely during pregnancy. Women should be advised that despite the short-term exacerbation during pregnancy, the long-term risk of progressive retinopathy remains unchanged. Thus, glycemic control should remain a priority during pregnancy. Of note, women who develop gestational diabetes are not at risk for retinopathy.

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