妊娠合并糖尿病发生羊水过多的可能机制研究进展

Research Progress of Possible Mechanisms of Polyhydramnios in Pregnancy Complicated with Diabetes Mellitus

羊水量的具体调节机制目前尚未完全阐明。羊水过多可引起母儿严重并发症,其临床症状不明显,常在妊娠中晚期通过超声检查发现并诊断,与母体高血糖及胎儿畸形等高危因素有关。妊娠合并糖尿病患者羊水过多的发生率较高,可能与母体长期高血糖引起羊水葡萄糖浓度升高、胎儿高血糖与渗透性利尿、巨大儿多尿、胎儿畸形以及水通道蛋白表达失调等有关。因此,整个孕期控制母体血糖水平稳定是降低妊娠合并糖尿病患者羊水过多的发生率、改善母儿预后的有效措施。

The specific regulatory mechanism of amniotic fluid volume has not yet been fully elucidated.Excessive amniotic fluid can cause serious complications in both mother and fetus,with unclear clinical symptoms.It is often detected and diagnosed through ultrasound examination in the middle and late stages of pregnancy,and is related to high-risk factors such as maternal hyperglycemia and fetal malformations.The incidence of polyhydramnios in pregnant women with diabetes is high,which may be related to the increase of amniotic fluid glucose concentration,fetal hyperglycemia and osmotic diuresis,polyuria in macrosomia,fetal malformation,and the imbalance of aquaporin expression caused by long-term maternal hyperglycemia.Therefore,controlling the maternal blood glucose level during the whole pregnancy is an effective measure to reduce the incidence of polyhydramnios in pregnant women with diabetes and improve the maternal and child prognosis.