[The value of estimating the levels of amniotic insulin which come from the fetus in looking after diabetic pregnancies in the last trimester (author's transl)].
The authors carried out 49 estimations of amniotic fluid levels of insulin in 41 patients. 25 of these patients were non-diabetic and they were a control group, and 16 patients were diabetic (24 estimations). The liquor was collected by amniocentesis between the 32nd and the 42nd week of amenorrhoea. The mean of the control levels was 3.17 micro-units per ml. The mean of the values in diabetic pregnancies was 9.97 micro-units per ml. The difference between the two groups is statistically significant. We have studied this insulinaemia in relationship to the duration of the diabetes, the maternal weight increase, the levels of insulin used therapeutically, the blood glucose level, the rise in arterial blood pressure, the weight of the infant, the date of delivery, the presence of fetal distress and the control of blood sugar. There is a statistically significant difference between the insulinaemia of patients in whom the diabetes is well controlled (mean level of 7.08 micro-units per ml) and the patients in whom the diabetes is badly controlled (31.7 micro-units per ml). This new parameter for supervision of the third trimester of pregnancy in diabetics gives rise to the possibilities of a better approach to materno-fetal blood sugar regulation and to an adjustment of the therapeutic doses of insulin that are given which will result in lengthening of the duration of pregnancy, with the aim of achieving a spontaneous vaginal delivery at term.
D000649:Amniocentesis; D000653:Amniotic Fluid / Q000032:analysis*; D001724:Birth Weight; D005260:Female; D006801:Humans; D007328:Insulin / Q000032:analysis*; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011254:Pregnancy in Diabetics
D007328:Insulin
Intérêt du dosage de l'insuline amniotique d'origine foetale dans la surveillance des grossesses de diabétique au dernier trimestre.