合并糖尿病性增殖性视网膜病变的妊娠

Pregnancies complicated by diabetic proliferative retinopathy.

作者信息

Lauszus F F, Grøn P L, Klebe J G

机构信息

Gynecological and Obstetrical Unit, Dept. Y, Skejby Hospital, Aarhus, Denmark.

出版信息

Acta Obstet Gynecol Scand. 1998 Sep;77(8):814-8.

PMID:9776594

Abstract

BACKGROUND

To examine retinal and pregnancy outcome in insulin-dependent diabetic women with proliferative retinopathy and assess the effect of albuminuria on morbidity.

METHODS

The records of 26 women with known proliferative retinopathy before pregnancy were studied retrospectively in the prepregnancy period, during pregnancy, and after delivery. Perinatal and maternal morbidity was studied using ophthalmic, obstetric and pediatric records.

RESULTS

Seven pregnancies were delivered preterm (27%). Serious neonatal morbidity occurred in five pregnancies (19%). Perinatal survival was 88%. Laser treatment was given prior to pregnancy to 54%, during pregnancy to 27% and after delivery to 31% of the women. Laser treatment during pregnancy was more common in those with no prior photocoagulation and in White class F/R. Low birthweight was more frequently associated with nephropathy and proliferative retinopathy compared to retinopathy alone (p<0.05). Recent hemorrhage, maculopathy or glaucoma was found in 14 (54%) of the women. Blindness developed unilaterally in two women.

CONCLUSIONS

Perinatal morbidity was associated with nephropathy rather than retinopathy. The incidence of hemorrhage, maculopathy or glaucoma was similar in White classes R and F/R.

摘要

背景

研究胰岛素依赖型糖尿病合并增殖性视网膜病变女性的视网膜及妊娠结局，并评估蛋白尿对发病率的影响。

方法

对26例妊娠前已知患有增殖性视网膜病变的女性记录进行回顾性研究，涵盖妊娠前期、妊娠期及产后。通过眼科、产科及儿科记录研究围产期及孕产妇发病率。

结果

7例妊娠早产（27%）。5例妊娠发生严重新生儿发病率（19%）。围产期存活率为88%。54%的女性在妊娠前接受激光治疗，27%在妊娠期接受治疗，31%在产后接受治疗。妊娠期激光治疗在未接受过光凝治疗者及White F/R级中更为常见。与单纯视网膜病变相比，低出生体重与肾病及增殖性视网膜病变的关联更为频繁（p<0.05）。14例（54%）女性发现近期出血、黄斑病变或青光眼。2例女性单侧失明。