TY - JOUR A2 - Hoesli，艾琳AU - 侯赛因，S.艾哈迈德AU - 史密斯，艾丽莎M. AU - 克罗斯，詹妮弗A. PY - 2020 DA - 2020年3月11日TI - 糖尿病，胎儿死亡和肩难产：8142109 VL - - 葡萄糖的筛选，以防止灾难性产科结局SP的重要性2020 AB - 糖尿病与死胎和肩难产的风险增加有关。无并发症妊娠相比，糖尿病患者有死胎和肩难产的风险2-3倍的4-6x风险。A 34 yo G2P0010 presented with a 40+3 wga IUFD with nonstandard antenatal glucose screening. Admission labs included a hemoglobin A1c of 6.6. She had a vaginal delivery complicated by a 30-minute shoulder dystocia that was not relieved by McRoberts, suprapubic pressure, Rubin II, Wood’s Screw, or posterior arm delivery. Nitroglycerine was administered, after which Wood’s Screw was successful resulting in delivery of an infant weighing 4190 grams (85th percentile for gestational age). A 31 yo G1 presented with a 37+1 wga IUFD. Her 28 wga three-hour GTT was notable for an elevated value at one hour (216 mg/dL). Admission labs included a hemoglobin A1c of 6.6. She had a vaginal delivery complicated by a 30-minute shoulder dystocia that was relieved via posterior axillary sling after failure of McRoberts, suprapubic pressure, Rubin II, Wood’s Screw, and Gaskin’s, resulting in the delivery of an infant weighing 3590 g (92nd percentile for gestational age). We present two cases of severe shoulder dystocia in patients who both presented with term IUFD and diabetic-range hemoglobin A1c. There is minimal literature on diabetic patients with pregnancies affected by both stillbirth and shoulder dystocia. These cases underscore the importance of glucose screening and control to prevent catastrophic obstetric outcomes. SN - 2090-6684 UR - https://doi.org/10.1155/2020/8142109 DO - 10.1155/2020/8142109 JF - Case Reports in Obstetrics and Gynecology PB - Hindawi KW - ER -