Document Detail


Three consecutive pregnancies in a patient with glycogen storage disease type IA (von Gierke's disease).
MedLine Citation:
PMID:  8203427     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Glycogen storage disease type IA is associated with metabolic abnormalities that can compromise fetal outcome. Normal outcome can be achieved by maintaining euglycemia throughout gestation. We report three consecutive pregnancies in a patient with glycogen storage disease type IA. The patient, a 35-year-old woman, has been maintained on a regimen of nightly nasogastric or cornstarch feedings for the past 12 years with improving metabolic control, reduced liver size, and no progression of multiple hepatic adenomas. On confirmation of each pregnancy, early in the first trimester nightly feeding was changed from cornstarch ingestion to Polycose by nasogastric intubation, with good metabolic control. During the last trimester of each pregnancy metabolic control showed further improvement, with lowering of lactate, urate, and triglyceride levels. During the first pregnancy unexpected fetal death occurred at 33 weeks. During the last two pregnancies, the patient was admitted at 33 and 34 weeks, respectively, for closer supervision of metabolic status and fetal monitoring. She underwent a cesarean section at 35 weeks 4 days of gestation and was delivered of a girl. She underwent a repeat cesarean section at 35 weeks 2 days for the subsequent gestation and was delivered of a boy. Both infants are healthy and appear to be unaffected by von Gierke's disease. Hepatic adenomas did not enlarge during the pregnancies. Meticulous management resulted in normal pregnancy outcomes in two consecutive gestations. Rapid fetal growth late in the third trimester may require particularly careful supervision to maintain euglycemia.
Authors:
I P Ryan; R J Havel; R K Laros
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  170     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1994 Jun 
Date Detail:
Created Date:  1994-07-07     Completed Date:  1994-07-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1687-90; discussion 1690-1     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco 94143-0556.
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MeSH Terms
Descriptor/Qualifier:
Adult
Dietary Carbohydrates / therapeutic use
Female
Fetal Death
Glucans / therapeutic use
Glucose / administration & dosage
Glycogen Storage Disease Type I / diet therapy*
Humans
Pregnancy
Pregnancy Complications / diet therapy*
Starch / therapeutic use
Chemical
Reg. No./Substance:
0/Dietary Carbohydrates; 0/Glucans; 50-99-7/Glucose; 9005-25-8/Starch

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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