妊娠期糖耐量受损阴道试产时机的探讨  

Exploration of occasion of natural delivery with gestational impaired glucose tolerance

作　　者：杨悦[1] 高文凯[1] 刘海鹰[1] 崔蕾[1] 

机构地区：[1]民航总医院,北京100123

出　　处：《西部医学》2010年第4期697-699,共3页Medical Journal of West China

摘　　要：目的探讨妊娠期糖耐量受损（GIGT）阴道试产的时机。方法对2007年1月-2008年12月189例单胎头位自愿选择阴道试产的GIGT产妇资料进行分析：按血糖控制是否满意分成两组，观察两组孕产妇并发症及胎婴儿分娩结局，终止妊娠的孕周与剖宫产率的相关性。结果血糖控制不满意组较满意组的妊娠期高血压疾病、羊水过多、新生儿窒息、新生儿低血糖发生比例增高，但差异无统计学意义（P〉0．05）。而胎膜早破、巨大儿、胎儿窘迫、剖宫产率比较差异有统计学意义（P〈0．05）。血糖控制满意组剖宫产率不随孕周增加，血糖控制不满意组胎儿窘迫、新生儿窒息的发生增加。结论血糖控制满意是减少母儿不良结局的关键。血糖控制不满意的GIGT孕妇宜近预产期终止妊娠。对血糖控制满意的GIGT孕妇允许在监测下待产，延期后给予引产。如果根据血糖控制情况，结合妊娠晚期对胎儿生长发育、宫内情况的监测，可以科学地选择试产时机，制定个体化分娩方案，达到母儿安全的目的。Objective To explore the occasion of the natural delivery with gestational impaired glucose tolerance. Methods 189 patients with natural delivery were analyzed. The cases were divided into 2 groups based on their blood glucose control. The complications, the outcome of the fatal and infant delivery and the weeks to terminate the pregnancy was observed. Results The incidences of hypertensive disorders in pregnancy, polyhydramnios, neonatal asphyxia and low blood sugar in infants were high in good blood glucose control group than that in bad blood glucose control group. The difference of premature rupture of membrane, fetal macrosomia, fetal distress and the rate of cesarean section between the 2 groups was statistically significant （P〈0. 05）. The rate of cesarean section in good blood glucose control did not increase with the weeks of pregnancy. Conclusions The good control of the blood glucose is the key in decrease of the bad outcome of the mother and infant.

关 键 词：妊娠期糖耐量受损 阴道试产 时机 

分 类 号：R714.3[医药卫生—妇产科学] R714.256[医药卫生—临床医学]