在怀孕期间患有严重胎儿缺氧的糖尿病酸性症:叙事综述和案例研究
Julia Mam-Lam-Fouck1, Meryam Cheloufi1, Agnès Rigouzzo2
1Department of Gynecology & Obstetrics, Trousseau Hospital, Sorbonne Université, APHP, Paris, 75012, France.
概括
糖尿病酸性脂肪酸 (DKA) 在怀孕期间,即使血糖正常 (euglycemic DKA),也存在风险. 在患有1型糖尿病的孕妇中,早期识别和治疗DKA对于有利的孕产妇和胎儿结果至关重要.
科学领域:
- 产科和妇科 产科和妇科
- 内分泌学 在内分泌学.
- 新生儿科学 新生儿科学
背景情况:
- 怀孕期间的糖尿病酸性脂肪酸症 (DKA) 是一种严重并发症,与高的孕产妇和产周发病率和死亡率有关.
- 优糖性DKA,发生在正常血糖水平时,是一种已知的变种,可以影响孕妇,特别是1型糖尿病患者.
研究的目的:
- 在患有1型糖尿病的孕妇患者中报告euglycemic DKA病例.
- 突出早期识别和在怀孕期间迅速治疗DKA的重要性,以改善孕产妇和胎儿的结果.
主要方法:
- 一个28岁的原发性糖尿病患者的病例报告,患有1型糖尿病,出现了暗示DKA的症状.
- 临床评估包括血糖,水平,离子间隙,血清二碳酸盐和心脏病学图.
- 治疗包括静脉注射水分,胰岛素治疗和由于胎儿痛苦而紧急剖腹产.
主要成果:
- 患者最初出现了轻微的症状和边界葡萄糖水平,但后来发展出严重的DKA与胎儿痛苦.
- 进行了紧急剖腹产,尽管有初始胎儿酸性化,但结果是新生儿的良好结果.
- 通过标准的医疗干预措施成功治疗了DKA.
结论:
- 优糖性DKA可能发生在患有1型糖尿病的孕妇身上,需要密切监测.
- 在怀孕期间及时诊断和管理DKA对于预防不良的孕产妇和胎儿并发症至关重要.
- 紧急剖腹产可能适用于DKA与胎儿痛苦的病例,以改善新生儿的结果.
相关概念视频
01:20Pathophysiology of Diabetes
921
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
921
01:24Diagnosing Acidosis and Alkalosis
203
Diagnosing acid-base imbalances involves systematically analyzing arterial blood samples, focusing on three key measurements: pH, bicarbonate (HCO3−) concentration, and carbon dioxide partial pressure (PCO2). This analysis follows a four-step process that helps identify the imbalance's underlying cause and nature.
First, the pH level is assessed to determine whether the blood pH is normal (7.35–7.45), low (acidosis), or high (alkalosis).
Next, the PCO2 and...
First, the pH level is assessed to determine whether the blood pH is normal (7.35–7.45), low (acidosis), or high (alkalosis).
Next, the PCO2 and...
203
01:22Diabetes Mellitus: Type 2 and Gestational
2.3K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.3K
01:30Acute Respiratory Failure-III
183
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
183
01:29Disorders of Acid-Base Balance
192
The human body maintains a precise pH range of arterial blood between 7.35 and 7.45. Deviations result in either acidosis (pH < 7.35) or alkalosis (pH > 7.45). These conditions are further classified as respiratory or metabolic disorders based on their underlying cause.
Respiratory Acidosis and Alkalosis
Respiratory acidosis occurs due to an increase in the partial pressure of carbon dioxide PCO2 in the blood. It often arises from shallow breathing or impaired gas exchange caused by...
Respiratory Acidosis and Alkalosis
Respiratory acidosis occurs due to an increase in the partial pressure of carbon dioxide PCO2 in the blood. It often arises from shallow breathing or impaired gas exchange caused by...
192
01:21Acute Respiratory Failure-II
217
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
217