控制满意的妊娠期糖尿病分娩时机与围产风险研究  

Study on the time of delivery and pregnancy outcomes in good control of gestational diabetes mellitus

作　　者：刘奕[1] 赵新儿[1] 邱笑飞[1] 戴蜜蜜[1] 邱海凡[1] 虞慧君[1] 

机构地区：[1]温州医科大学附属二院妇产科

出　　处：《中国临床药理学与治疗学》2014年第5期552-556,共5页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：温州市医药卫生科技计划项目(Y20130125)

摘　　要：目的：探讨控制满意的妊娠期糖尿病（GDM）患者是否需要提前引产。方法：选取2010．1～2013．1间就诊于温州医科大学附属第二医院产科的GDM患者，选取其中经个体化医学营养治疗和运动疗法血糖控制满意且孕周≥28周的单胎妊娠纳入观察范围，定期随访，监测母儿情况直至孕38周，剔除不符合要求的受试者，确定对象180例。随机分成引产组83例和期待组97例。引产组孕38周行宫颈成熟度检查后引产；期待组不做特殊处理，每周产前门诊复诊直至自然临产，或在出现母儿并发症时终止妊娠。结果：引产组剖宫产率低于期待组，母儿并发症如产后出血、羊水过多、羊水过少、胎儿宫内窘迫、新生儿窒息明显低于期待组，差异具有统计学意义（P〈0．05）。两组新生儿出生体重及巨大儿发生率无明显区别（P〉0．05）。BMI〉25（kg／m^2），空腹血糖（FBG），口服葡萄糖耐量试验（OGTT 2h），餐后2h血糖波动〉2mmol／L，是期待GDM分娩时机产妇发生不良妊娠的相关危险因素。结论：控制满意的GDM孕妇，分娩孕周不宜过迟，特别是伴有上述危险因素的孕妇，孕38周即可考虑适时终止妊娠。AIM. To investigate the time of delivery and pregnancy outcomes in good control of gestational diabetes mellitus. METHODS： 180 single pregnancies with gestational diabetes treated with medical nutrition therapy and kinesitherapy were observed from 28 to 38 weeks in the second Affilated Hospital of Wenzhou Medical University from jan 2010 to Jan 2013. All the patients had been divided into two groups：83 for labour group and 97 for expectant group. Labour inducted to the patients after cervix maturation examing for labour guoup since 38 weeks. Nothing special done to expectant group until nature parturient or labour for gestational period complication. RESULTS.There is a low cesarean section rate in labour group compares to expectant group as while as postpartum hemorrhage, polyhydramnios, oligoamnios, fetal distress, neonatal asphyxia（P〈0.05）. There is no significant difference in neonate birth weight and fetal macrosomia between the two groups （P 〉 0.05）. BMI 〉 25 （ kg/m2 ）, fasting blood glucose （FBG）, oral glucose tolerance test（OGTT 2 h）, food control blood sugar are not satisfied, dissatisfied with insulin to control blood sugar Gestational diabetes is expected timing of delivery of maternal adverse pregnancy related risk factors. CONCLUSION： Delivery should be considered to the good control gestational diabetes mellitus after 38 weeks, especially those associated with these risk factors in pregnant women.

关 键 词：妊娠期糖尿病 满意控制 分娩时机 

分 类 号：R587.1[医药卫生—内分泌]