ABSTRACT
This chapter highlights factors of importance for the clinical care of pregnant women with diabetic nephropathy or microalbuminuria with particular focus on the possible role of strict antihypertensive treatment during pregnancy. Preeclampsia is characterized by hypertension, proteinuria, and peripheral edema developing after 20 gestational weeks. The authors suggest that the increased prevalence of preeclampsia in women with type 1 diabetes complicated with diabetic nephropathy or microalbuminuria is mainly related to common maternal constitutional factors with an increased susceptibility to endothelial dysfunction. Low-dose aspirin treatment is indicated in women with diabetic nephropathy or microalbuminuria to prevent cardiovascular events, and it might also prevent preeclampsia. Daily folic acid supplementation should be advised as it might reduce the risk of fetal malformations. Most information in the literature comes from women with type 1 diabetes and diabetic nephropathy or microalbuminuria, but the same numbers are probably also valid for women with type 2 diabetes.
