10年间妊娠合并糖尿病发生状况及母儿结局的变化

The Variation Of Occurrence Stuation And Materanl and Fetal Outcome in Preganancy with Overt Diabetes over 10 years

目的探讨10年间妊娠合并糖尿病发生状况及母儿结局的变化，并分析其原因。方法近10年我院妊娠合并糖尿病孕妇共计58例，将其分成两组，1994年1月～1998年12月前5年19例患者作为A组，1999年1月～2003年12月后5年39例患者作为B组，对两组资料中孕妇一般情况、病情严重程度、治疗情况及分娩方式、围产儿并发症等情况进行比较分析和统计学处理。结果①A组孕妇孕晚期体重指数（BMI）、年龄、正规产检率、无症状患者均明显低于B组，其确诊孕周晚于B组；②A组治疗前空腹血糖值、酮症酸中毒发生率、早产率均高于B组；③A组单纯饮食控制不佳需加用胰岛素者及血糖控制不良率高于B组，A组经阴道产钳助产率亦高于B组；④A组围产儿并发症，死胎发生率、新生儿窒息率、IRDS发生率均高于B组。结论妊娠合并糖尿病对母儿可造成多种危害，近5年妊娠合并糖尿病发生率虽上升，但母儿并发症并未相应增多，与孕妇健康意识增强、孕期进行筛查，早发现，早治疗密切相关。

Objective To discuss the variation of occurrence stuation and materanl and fetal outcome in pregnanacy with overt diabetes over 10 years,and analyse the masons. Methods Retrospective study was made on 58 pregnancies with obert diabetes. We divided the 58 cases into two groups ,Group A had 19 cases from 1994 - 1998 ,group B had 39 cases from 1999 - 2003. We compared the clinical data of the two groups. Results ①The B MI, age, the rate of anternate care and non- syntom cases in group A were lower than those in group B. ②Before treatment, the level of blood glucose, the rate of ketoacidemia and the rate of premature labor in group A were significantly higher than those in group B. ③The cases who needed dietary treatment combining injecting Insulin and with poor - controlled glucose in group A were more than those in group B. ④The perinatal complications in group A were significantly higher than those in group B. Conclusion Augmentating management of pregnanacy with overt diabetes can reduce effectively the incidence of complications of the mothers and fetals.