妊娠中晚期糖尿病患者胎儿心脏功能评估及出生后随访数据分析

Evaluation of fetal heart function andpost-natal follow-up data analysis of patients with diabetes in the second and third trimester of pregnancy

目的:探讨妊娠中晚期糖尿病患者胎儿心脏功能评估及出生后随访数据分析。方法:选取来邢台市第三医院进行产检的120例疑似妊娠期糖尿病孕妇作为研究对象,其中,54例孕妇被确诊作为观察组,其余66例孕妇作为对照组。对两组孕妇妊娠中晚期进行超声心动图检查。分析观察组、对照组心脏构型指标与心功能指标,对观察组选择继续妊娠的孕妇进行随访,分析其胎儿心脏异常情况。结果:在心脏构型指标方面,观察组在LVDS、RVDS、LVDd以及RVDd方面差异无统计学意义(P>0.05),观察组IVSs、IVSd高于对照组,差异具有统计学意义(P<0.05);观察组左心室MPI、右心室MPI、LVWT、RVWT高于对照组胎儿,其E/ATV、E/AMV低于对照组胎儿,差异具有统计学意义(P<0.05);经出生后随访数据可知,观察组54例胎儿中,共出现15例心脏异常情况,二尖瓣或是三尖瓣轻度反流4例,心室间隔缺损6例,法洛四联症2例,二尖瓣或三尖瓣严重狭窄或闭锁2例,完全性房室间隔缺损1例;对照组66例胎儿中,共出现2例心脏异常情况,即二尖瓣或是三尖瓣轻度反流2例。结论:超声心动图能够对中晚期妊娠期糖尿病孕妇胎儿心脏功能进行有效检测,在产前采用超声心动图检测,能够减少胎儿严重先心病的出生率。

Objective:To investigate the evaluation of fetal heart function in patients with diabetes in the second and third trimester of pregnancy and the analysis of post-natal follow-up data.Methods:120 suspected pregnant women with gestational diabetes were selected as the study objects in the Third Hospital of Xingtai City.Among them,54 pregnant women were confirmed as the observation group and the other 66 pregnant women as the control group.Echocardiography was performed in the second and third trimesters of the two groups.The cardiac configuration indexes and cardiac function indexes of the observation group and the control group were analyzed.The pregnant women in the observation group were followed up to analyze the fetal heart abnormalities.Results:There was no significant difference in LVDS,RVDS,LVDd and RVDd in the observation group(P>0.05),while IVSs and IVSd in the observation group were higher than those in the control group(P<0.05).The left ventricular MPI,right ventricular MPI,LVWT and RVWT of the observation group were higher than those of the control group,and the E/ATV and E/AMV of the observation group were lower than those of the control group,the difference was statistically significant(P<0.05).According to the postnatal follow-up data,of the 54 fetuses in the observation group,15 had abnormal heart conditions,4 had mild mitral or tricuspid valve regurgitation,6 had ventricular septal defect,2 had tetraloflot,2 had severe mitral or tricuspid valve stenosis or atresia,and 1 had complete atrioventricular septal defect.In the control group of 66 fetuses,there were 2 cases of cardiac abnormality,that is,2 cases of mild mitral or tricuspid valve regurgitation.Conclusion::Echocardiography can effectively detect fetal heart function in pregnant women with middle and late gestational diabetes,and prenatal echocardiography can reduce the birth rate of fetal severe congenital heart disease.