Nebashi Hikari, Matsui Hitoshi, Tei Chika, Hasebe Masanori, Takanashi Hiroko
Department of Obstetrics and Gynecology, Chigasaki Municipal Hospital, 5-15-1 Honson, Chigasaki, Kanagawa 253-0042 Japan.
Department of Endocrinology and Diabetology, Chigasaki Municipal Hospital, Chigasaki, Kanagawa 253-0042 Japan.
Diabetol Int. 2024 Mar 12;15(3):589-593. doi: 10.1007/s13340-024-00706-9. eCollection 2024 Jul.
Pregnancy-associated fulminant type 1 diabetes (PF) has received high clinical attention because of its low incidence and poor prognosis. It poses a great threat to the lives of mothers and infants; therefore, it is imperative to understand its characteristics and approach methods. However, no studies have described whether a cesarean section or conservative treatment should be considered at the onset of PF. We report a case of PF, review the published literature and consider a cesarean section at the onset of PF. A 39-year-old woman was admitted to our hospital with dyspnea and nausea. The patient was diagnosed with PF. Insulin Lispro and Glargine were administered to control the blood glucose levels. Six hours later, the fetus died. The fetal status due to PF probably worsened during the conservative treatment. No perioperative complications have been reported for cesarean sections under diabetic ketoacidosis due to PF and there have been cases of live birth by emergency cesarean section. Identifying the features of PF and considering and performing cesarean sections early after diagnosis is essential to save fetal life.
妊娠相关暴发性1型糖尿病(PF)因其发病率低且预后差而受到高度临床关注。它对母婴生命构成巨大威胁;因此,了解其特征和处理方法势在必行。然而,尚无研究描述在PF发病时应考虑剖宫产还是保守治疗。我们报告一例PF病例,回顾已发表的文献并考虑在PF发病时进行剖宫产。一名39岁女性因呼吸困难和恶心入住我院。该患者被诊断为PF。给予赖脯胰岛素和甘精胰岛素以控制血糖水平。6小时后,胎儿死亡。由于PF,在保守治疗期间胎儿状况可能恶化。对于因PF导致糖尿病酮症酸中毒情况下的剖宫产,未报告围手术期并发症,并且有急诊剖宫产活产的病例。识别PF的特征并在诊断后尽早考虑并进行剖宫产对于挽救胎儿生命至关重要。