Cotteel M, Goeusse P, May J P, Fourlinnie J C, Puech F, Leroy J L, Delecour M
J Gynecol Obstet Biol Reprod (Paris). 1981;10(6):555-9.
The authors carried out 49 estimations of amniotic fluid levels of insulin in 41 patients. 25 of these patients were non-diabetic and they were a control group, and 16 patients were diabetic (24 estimations). The liquor was collected by amniocentesis between the 32nd and the 42nd week of amenorrhoea. The mean of the control levels was 3.17 micro-units per ml. The mean of the values in diabetic pregnancies was 9.97 micro-units per ml. The difference between the two groups is statistically significant. We have studied this insulinaemia in relationship to the duration of the diabetes, the maternal weight increase, the levels of insulin used therapeutically, the blood glucose level, the rise in arterial blood pressure, the weight of the infant, the date of delivery, the presence of fetal distress and the control of blood sugar. There is a statistically significant difference between the insulinaemia of patients in whom the diabetes is well controlled (mean level of 7.08 micro-units per ml) and the patients in whom the diabetes is badly controlled (31.7 micro-units per ml). This new parameter for supervision of the third trimester of pregnancy in diabetics gives rise to the possibilities of a better approach to materno-fetal blood sugar regulation and to an adjustment of the therapeutic doses of insulin that are given which will result in lengthening of the duration of pregnancy, with the aim of achieving a spontaneous vaginal delivery at term.
作者对41例患者进行了49次羊水胰岛素水平测定。其中25例患者无糖尿病，作为对照组，16例患者患有糖尿病（进行了24次测定）。在闭经第32至42周期间通过羊膜穿刺术采集羊水。对照组水平的平均值为每毫升3.17微单位。糖尿病妊娠患者的值的平均值为每毫升9.97微单位。两组之间的差异具有统计学意义。我们研究了这种胰岛素血症与糖尿病病程、母亲体重增加、治疗所用胰岛素水平、血糖水平、动脉血压升高、婴儿体重、分娩日期、胎儿窘迫的存在以及血糖控制的关系。糖尿病控制良好的患者（平均水平为每毫升7.08微单位）与糖尿病控制不佳的患者（31.7微单位每毫升）的胰岛素血症之间存在统计学显著差异。这个用于监测糖尿病患者妊娠晚期的新参数为更好地调节母胎血糖以及调整胰岛素治疗剂量提供了可能性，这将导致妊娠期延长，目标是足月时实现自然阴道分娩。
