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糖尿病妊娠的监测。关于34例胰岛素治疗病例

[Monitoring of the diabetic pregnancy. Apropos of 34 insulin-treated cases].

作者信息

Hieronimus S, Greck T, Grimaldi M, Fenichel P, Harter M, Gillet J Y

机构信息

Service de Gynécologie-Obstétrique, Hôpital Saint-Roch, Nice.

出版信息

Rev Fr Gynecol Obstet. 1987 Jul-Sep;82(7-9):497-503.

PMID:3313652
Abstract

This study concerns a series of 34 pregnant diabetic patients, insulin-dependent or requiring insulin, which were followed between January 1st 1980 and May 31st 1986. The blood level of glycolated hemoglobin (HbA1C) decreased constantly, demonstrating the improvement of the balance of the blood sugar, but its level, at the end of the pregnancy, could not be correlated with the presence of a macrosomia (27%) and/or of a neonatal hypoglycemia (24%). On the contrary, the infraclinical hypertrophy of the ventricular septum (HVS) diagnosed systematically by sonogram, and discovered in 6 newborns (nb) could represent a good marker of the harmful role of maternal hyperglycemia, even if moderate. Arterial hypertension, found in 8 cases, has a prognostic value as it is responsible for acute fetal distress (AFD), 2 cases, and for delivery by caesarean section (8 cases). A multidiscipline approach seems to improve the prognosis of pregnancy in diabetic patients, which nevertheless, should still be considered as a high-risk pregnancy.

摘要

本研究涉及1980年1月1日至1986年5月31日期间随访的34例胰岛素依赖型或需要胰岛素治疗的妊娠糖尿病患者。糖化血红蛋白(HbA1C)的血水平持续下降,表明血糖平衡得到改善,但其在妊娠末期的水平与巨大儿(27%)和/或新生儿低血糖(24%)的存在无相关性。相反,通过超声心动图系统诊断出的6例新生儿室间隔亚临床肥厚(HVS),可能是母亲高血糖有害作用的良好指标,即使是轻度高血糖。8例患者出现动脉高血压,具有预后价值,因为它导致2例急性胎儿窘迫(AFD)和8例剖宫产。多学科方法似乎可改善糖尿病患者的妊娠预后,然而,仍应将其视为高危妊娠。

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