| Popis: |
Results are shown obtained from 88 patients who were pregnant and diabetic, treated from November 1972 until November 1976 at the "Gonzalez Coro" Hospital and the Endocrinology Institute of Havana. These patients received a therapeutical regime which took into consideration an increase in the dosis of simple, regular insulin, until the "maximum tolerated dosis" was reached in each case, which was capable of situating this patient in a real prehipoglicemic status. Among the modifications which were introduced was the diet with calories requirements estimated attending to the weight, height and age of the pregnant women. We employed two classifications for the patients: that from Pricilla White modified by Pedersen, and our own institution's, which was aimed to know the "mother-fetus-prognosis". The group includes 17 patients of type A, 14 of type B, 20 of type C, 29 of type D and 8 of type F. These last ones were diagnosed through kidney-biopsia during the puerperium. A fix date for birth was not predeterminated; each patient was allowed to go ahead with her pregnancy until spontaneous delivery began. The rate of cesarean operation was 52%, and the weight of the newborns was within the average limits, except in 4 cases. The perinated death-rate of the group was 3,4% and the Apgar-score at the first minute of life was satisfactory in 79,5% of the group. It is concluded that the individual normoglicemia is essential for the control of the diabetic woman, and that mother's glicemia will have an effect on the fetus, producing a reduction of the gradient of mother-fetus glicemia and, on account of this, also a reduction of the hiperinsulinism reaction of the fetus with all its ill results. |
