- 作者：J. Lepercq ; H. Abbou ; C. Agostini ; F. Toubas ; C. Francoual ; G. Velho ; D. Dubois-Laforgue ; J. Timsit
- 关键词：Type ; 1 ; diabetes ; Pregnancy ; Delivery
- 刊名：Diabetes Metabolism
- 出版年：2008
- 出版时间：February 2008
- 年：2008
- 卷：34
- 期：1
- 页码：33-37
- 全文大小：202 K
AimTo evaluate a standardized protocol for maintaining near-normoglycaemia during labour and delivery in women with type 1 diabetes.Methods
Over a nine-year period (1997–2005), 229 pregnancies in 174 women with type 1 diabetes were delivered at one centre. The same regimen was used for the induction of labour (group 1) and in women admitted in spontaneous labour (group 2): 10 % dextrose (80 ml/h) intravenous was given along with short-acting insulin, starting at 1 IU/h intravenous via an infusion pump. Capillary blood glucose (CBG) was determined hourly, and the insulin infusion rate was modified accordingly.
Results
Labour was induced in 85 cases (37 % ) and spontaneous in 23 cases (10 % ), and an elective C-section was performed in 121 cases (53 % ). Maternal glycaemia during labour was 6.1 ± 1.6 (range: 3.9–9.2) mmol/l in group 1, and 6.9 ± 2.0 (range: 4.7–12.0) mmol/l in group 2. Maternal glycaemia at delivery was 5.8 ± 1.5 (range: 3.4–9.4) and 6.3 ± 1.9 (range: 4.1–11.4) mmol/l in groups 1 and 2, respectively. Women who underwent an elective C-section were not included in the standardized protocol and had higher glycaemia at delivery 7.1 ± 2.0 (range: 2.7–13.5) mmol/l. Neonatal hypoglycaemia occurred in 30 infants (13 % ), and was only associated with preterm delivery.
Conclusion
Using a standardized simple protocol during labour, maternal glycaemia was maintained within a near-normal range in 80–85 % of cases.