Embryofetopathia diabetica
| Classification according to ICD-10 | |
|---|---|
| P70.0 | Syndrome of a mother's child with gestational diabetes |
| P70.1 | Syndrome of the child of a diabetic mother
Pre-existing maternal diabetes mellitus affecting the fetus or newborn (with hypoglycemia) |
| ICD-10 online (WHO version 2019) | |
The Embryofetopathia diabetic is a prenatal developmental disorder due to an unrecognized, poorly controlled or decompensated diabetes mellitus of the mother during pregnancy .
pathology
The increased transfer of glucose to the fetus and the resulting increased blood sugar level in the fetus leads to an increased release of insulin (fetal hyperinsulinism). This results in the functional immaturity of the fetal organs (e.g. lungs, liver) and a so-called insulin mast ( hypertrophy of the organs and the fetus).
The development of high blood sugar levels in a pregnant woman can have various causes. One can distinguish three forms of diabetes:
- Gestational diabetes (1–2%) which regresses after birth, but can also persist
- Type 1 diabetes mellitus
- Type 2 diabetes mellitus (due to the age of the mother rather rare, but increasing)
diagnosis
The diagnosis is made by sonography and by means of a blood sugar test in the pregnant woman. The ultrasound shows a general enlargement of the fetus and any changes in the organs can be seen. The pancreas (β-cells), adrenal cortex and liver in particular can be enlarged but functionally immature. The birth weight is over 4000 g, the height over 55 cm.
consequences
Because of the embryofetopathia diabetica it occurs more frequently
- Premature births
- Placental insufficiency
- Death of the fetus in utero or during childbirth (perinatal mortality rate 5–20% without therapy)
- Shoulder dystocia
- neonatal adjustment disorders (e.g. hypoglycemia , hypocalcemia , hyperbilirubinemia , respiratory distress syndrome )
- long-term increased obesity, cardiovascular and metabolic pathologies.
The malformation rate is increased due to hydramnios. The effects on the fetus are also summarized under the term kyematopathia diabetica .
therapy
The therapy consists of a timely and optimal metabolic adjustment of the mother as well as the delivery on the calculated due date.
In type 1 diabetics, the HbA1c value must also be checked , since long-term increases above 8.5% have led to a significant increase in the malformation rate up to 22%.
literature
- Pschyrembel Clinical Dictionary. 257th edition.
- K. Knörr among others: Obstetrics and Gynecology. 3. Edition. Springer, 1989, ISBN 3-540-50757-4 .
