38. Phân tích một loạt ca bệnh thai phụ có thai chết lưu liên quan tới đái tháo đường tại Khoa Nội tiết - Đái tháo đường, Bệnh viện Bạch Mai

Abstract

Diabetes mellitus is associated with an increased risk of stillbirth in pregnancy. We conducted a retrospective study of 20 pregnant women with stillbirth related to diabetes mellitus from Jan 1, 2020 to December 31, 2023 to analyze the characteristics of pregnant women with stillbirth related to diabetes mellitus and identified risk factors for prevention. The mean age of the patients was 30.2 ± 7.4 years, with 70% under 35 years old. The mean gestational age at stillbirth was 30.2 ± 6.2 weeks. 65% of the patients were not diagnosed with diabetes mellitus before pregnancy. The mean HbA1c level was 9.0 ± 3.3%, with 65% having HbA1c ≥ 6.5%. The mean blood glucose level upon admission was 21.8 ± 10.3 mmol/L. 85% of the patient with stillbirth had metabolic acidosis with HCO₃ < 18 mEq/L, of which 65% had compensated metabolic acidosis with pH < 7.35. The results indicate that uncontrolled hyperglycemia, metabolic acidosis, and lack of screening diabetes are common risk factors in pregnant women with stillbirth related to diabetes mellitus. Early diagnosis and optimal blood glucose control are crucial for reducing the risk of fetal demise in this population.