Newcastle Diabetes Centre, Newcastle General Hospital, UK.
Best Pract Res Clin Obstet Gynaecol. 2011 Feb;25(1):77-90. doi: 10.1016/j.bpobgyn.2010.10.015. Epub 2010 Dec 4.
Pregnant women with diabetes have to manage both the effect of pregnancy on glucose control and its effect on pre-existing diabetic complications. Most women experience hypoglycaemia as a consequence of tightened glycaemic control and this impacts on daily living. Less commonly, diabetic ketoacidosis, a serious metabolic decompensation of diabetic control and a medical emergency, can cause foetal and maternal mortality. Microvascular complications of diabetes include retinopathy and nephropathy. Retinopathy can deteriorate during pregnancy; hence, regular routine examination is required and, if indicated, ophthalmological input. Diabetic nephropathy significantly increases the risk of obstetric complications and impacts on foetal outcomes. Pregnancy outcome is closely related to pre-pregnancy renal function. Diabetic pregnancy is contraindicated if the maternal complications of ischaemic heart disease or diabetic gastropathy are known to be present before pregnancy as there is a significant maternal mortality associated with both of these conditions.
患有糖尿病的孕妇必须同时应对妊娠对血糖控制的影响以及其对原有糖尿病并发症的影响。大多数女性会因血糖控制更加严格而出现低血糖，这会影响日常生活。不太常见的是，糖尿病酮症酸中毒是一种严重的糖尿病控制代谢失调，也是一种医疗急症，会导致胎儿和母亲死亡。糖尿病的微血管并发症包括视网膜病变和肾病。妊娠期间视网膜病变可能会恶化；因此，需要进行常规的例行检查，如果有必要，还需要眼科医生的介入。糖尿病肾病会显著增加产科并发症的风险，并影响胎儿结局。妊娠结局与孕前肾功能密切相关。如果在怀孕前就已知存在缺血性心脏病或糖尿病性胃轻瘫等母体并发症，则不建议进行糖尿病妊娠，因为这两种情况都会导致显著的母体死亡率。
