Coetzee E J, Jackson W P
S Afr Med J. 1981 Aug 15;60(7):275-8.
During a 5 1/2-year period we have seen only 39 pregnant women with insulin-dependent diabetes, as opposed to 171 with established insulin-independent diabetes. Tight control with two injections of mixed insulins per day was attempted, but satisfactory blood glucose values were obtained in only 16 cases. Nevertheless the overall perinatal mortality rate was 77/1000; of the 3 infants which died 2 had lethal congenital abnormalities and 1 was born to a mother whom we had been seeing for only 4 weeks. Perinatal morbidity was similar to that in other series, except that few of our infants were oversized, hyaline membrane disease was uncommon, and only 2 had a low Apgar score. Fourteen infants weighed less than 2500 g. Hypoglycaemia in the newborn appears to be much reduced by the use of continuous low-dose intravenous insulin infusion during labour or caesarean section. To reduce perinatal mortality further, we conclude that exact blood glucose control should be attained before conception.
在5年半的时间里，我们仅诊治了39例胰岛素依赖型糖尿病孕妇，而确诊的非胰岛素依赖型糖尿病孕妇有171例。我们尝试通过每天注射两次混合胰岛素进行严格控制，但仅16例患者获得了满意的血糖值。尽管如此，围产期总死亡率为77‰；在死亡的3例婴儿中，2例有致命的先天性异常，1例的母亲我们仅诊治了4周。围产期发病率与其他系列报道相似，只是我们的婴儿中巨大儿较少，透明膜病不常见，且只有2例阿氏评分低。14例婴儿体重不足2500克。分娩或剖宫产时使用持续低剂量静脉输注胰岛素似乎可大大降低新生儿低血糖的发生率。为进一步降低围产期死亡率，我们得出结论，应在受孕前实现精确的血糖控制。
