妊娠期糖尿病治疗及分娩时机选择的探讨

Study on the treatment of GDM and timing of delivery

目的探讨妊娠期糖尿病治疗及分娩时机的选择。方法对82例住院分娩妊娠期糖尿病孕妇的临床资料进行回顾性分析。结果血糖控制满意组新生儿发病率28.3%,血糖控制不满意组新生儿发病率62.1%,两组比较,差异有显著性(P<0.01)。胎龄<37周及>40周与胎龄在37～40周比较,新生儿发病率明显长高。有显著性差异。胎龄37～40周与38～40周新生儿发病率近似相同。孕39周羊水泡沫试验仍有阴性者,25例促胎肺成熟后仍有4例肺不成熟。结论在妊娠期糖尿病患者中,严格的血糖控制是非常必要的。分娩时间以孕37～40周为宜。促胎肺成熟有一定效果,未经血糖控制者胎肺成熟情况难以估计,终止妊娠前须行羊水泡沫试验以了解胎肺成熟情况。

Objective To explore the treatment of GDM and timing of delivery. Methods 82 patients with gestational diabetes mellitus were retrospectively studied. Results The neonatal morbility rate was 28.3% in good glucose control group, it was 62. 1% in poor glucose control group, the difference was significant （ P 〈 0. 01 ）. The neonatal morbility rate in 〈 37 gestational weeks increased obviously than that in 〉 40 or 37 - 40 gestational weeks. There was no significant difference in neonatal morbility between 37 - 40 and 〉 40 gestational weeks. 4 cases of negative foam test of amniotic fluid were found in 25 patients with 39 gestational weeks. Conclusion For patients with GDM, strict glucose control is important, appropriate timing of delivery is 37 40 gestational weeks, foam test of amniotic fluid should be performed to evaluate the lung maturity.