糖尿病妊婦の臨床(近畿地区における糖尿病妊婦診療の実態と管理上の問題点)

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タイトル別名
  • Clinical Survey on Pregnant Diabetics in Kinki District
  • トウニョウビョウ ニンプ ノ リンショウ

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Diabetes mellitus in pregnancy was studied in 32 hospitals in Kinki district, Japan, from 1974 to 1975. Of 49, 041 pregnant women studied, 198 cases (0.4%) were diabetics. According to the White's classification these diabetics were divided into 5 classes: class A were 135 cases, class B 54, class C 5, class D none, class E 3 and unclassified 1. Overt diabetes mellitus were 63 cases. Among 198 diabetics 68 (34.5%) had family history of diabetes mellitus. In 198 offsprings of diabetic mother, 7 cases (3.5%) of perinatal death were observed, being stillbirth 6 and death after birth 1. As far as complication during pregnancy is concerned, hydramnion was seen in 5 cases (2.5%), toxemia 61 (30.8%) (slight to moderate 26, severe 4, unkown 1), diabetic retinopathy 2 (1%), cataract 2 (1%), precoma or acidosis 2 (1%), hypoglycemia 2 (1%), infections 20 (21%). With respect to treatment of diabetes mellitus, patients only on diet control were 154 (78%), on insulin 32 (16.2%) and on oral drugs 4 (2%). Cases treated with insulin and oral drugs were 4. Of 198 cases, cesarean section performed was 36.<br>The average birth weight was 3316g;the babies over 4000g were 39 (19.7%), in which 11 cases (5.5%) were over 4500g. On the other hand, low birth weight was observed in 11 cases and the lightest was 910g. No significant sex difference in offspring of diabetic mother was observed, being 104/94. Malformation was seen in 2 cases (cleft plate and brain anomaly), hypoglycemia in 26, IRDS in 8, hyperbilirubinemia in 33, in which 2 received exchange blood transfusion and the others were treated with ultraviolettherapy.<br>Improvement of diabetes mellitus of mother was seen in 75 cases after delivery, but 98 cases were unchanged and 4 cases deteriorated.

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