超声在评估妊娠期糖尿病胎儿有无过度增长风险分析中的应用

目的：探讨超声在评估妊娠期糖尿病（gestational diabetes mellitus，GDM）孕妇胎儿的体质量、预测胎儿有无过度增长风险中的作用，给临床提供合理化的指导意见。方法回顾分析133例GDM孕妇，随访孕妇至分娩，随机挑选450例非糖尿病孕妇做对照，糖尿病孕妇于妊娠（27∽28、31∽32、35∽36周、分娩前）超声测量胎儿双顶径、头围、腹围、股骨径等，评估胎儿的体质量，探讨胎儿体质量与胎儿过度增长的关系。结果 GDM孕妇巨大儿的发生率为10.52%（14/133），显著高于非糖尿病组的2.22%（10/450），2组差异具有统计学意义（P〈0.05）；GDM组中巨大儿及非巨大儿在27∽28、31∽32、35∽36周，超声评估胎儿的体质量，其差异具有统计学意义（P〈0.05）。结论超声对GDM孕妇胎儿体质量的不同孕周的监测，可以预测胎儿有无过度增长的风险，从而控制巨大儿的发生，改善妊娠结局。

Objective To explore the effect of ultrasound on the assessment of gestational diabetes mellitus （gestational diabetes mellitus, GDM） prediction of fetal weight, fetal have without the risk of excessive growth, and provide guidance to clinical rational. Methods A retrospective analysis was performed on133 case of GDM women, all of the cases were tracked until delivery. 450 cases of non diabetic pregnant women were selected as the control. Fetal biparietal diameter, head circumference, abdominal circumference, femur diameter etc.of pregnant women with diabetes mellitus in pregnancy （27∽28, 31∽32, 35∽36 weeks, before delivery） were given ultrasonic measurement. Fetal weight was Estimated,the relationship between fetal weight and the excessive growth of fetus were explored. Results The incidence of GDM in pregnant women of fetal macrosomia was10.52%（14/133）, signiifcantly higher than the non diabetes mellitus group of 2.22%（10/450）, with a signiifcant difference between two groups （P〈0.05） GDM group of fetal macrosomia and non macrosomia in 27∽28, 31∽32, 35∽36 weeks, fetal weight was given ultrasound evaluation, with statistical difference （P〈0.05）. Conclusion Ultrasonic monitoring in GDM fetal weight in different pregnant weeks can predict fetal have without the risk of excessive growth, so as to control the incidence of macrosomia, and improve the pregnancy outcome.