Szabó M, Tóth T, Tóth Z, Szeifert G T, Csécsei K, Veress L, Papp Z
Zentralbl Gynakol. 1986;108(20):1228-36.
Diabetic pregnant patients belong to a high-risk group from a genetic counselling point of view. Therefore serum AFP estimation and ultrasound examination was carried out in 36 diabetic pregnancies, between the 16-20 gestational weeks. Healthy infants were delivered in 28 cases, fetal malformations or diseases were diagnosed in 3 cases (2 exencephaly and 1 polycystic kidney disease), 5 pregnancies ended up with stillbirth and/or severe fetopathy. According to our findings, the feto-maternal AFP balance is altered in poorly controlled diabetic pregnant patients. Therefore the maternal serum AFP concentration does not always reflect the AFP content of amniotic fluid. It is supposed that the low serum AFP concentration in diabetic patients is due to the disturbed AFP balance, which cannot be observed in well controlled pregnant diabetics. In the pregnancy of diabetic mothers both serum AFP and ultrasound examination should be carried out. With further improvement in the preconceptional treatment of diabetic patients not only the number of malformations caused by hyperglycaemia should diminish, but the problems of false negative and false positive serum AFP values caused by the disturbance in carbohydrate metabolism should also become less frequent.
从遗传咨询的角度来看，糖尿病孕妇属于高危群体。因此，对36例妊娠16至20周的糖尿病孕妇进行了血清甲胎蛋白（AFP）测定和超声检查。28例分娩出健康婴儿，3例诊断出胎儿畸形或疾病（2例无脑儿和1例多囊肾疾病），5例妊娠以死产和/或严重胎儿病变告终。根据我们的研究结果，血糖控制不佳的糖尿病孕妇的母胎AFP平衡发生了改变。因此，孕妇血清AFP浓度并不总是反映羊水的AFP含量。据推测，糖尿病患者血清AFP浓度较低是由于AFP平衡紊乱所致，而在血糖控制良好的糖尿病孕妇中未观察到这种情况。对于糖尿病母亲的妊娠，应同时进行血清AFP测定和超声检查。随着糖尿病患者孕前治疗的进一步改善，不仅高血糖引起的畸形数量应减少，而且碳水化合物代谢紊乱导致的血清AFP假阴性和假阳性问题也应变得不那么频繁。
