妊娠期糖尿病并发子痫前期对脐动脉血流的影响

The influences of gestational diabetes complicating preeclampsiaon umbilical artery

目的探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)并发子痫前期(preeclampsia,PE)对胎儿脐动脉血流的影响。方法选取某院产妇165例,其中妊娠期糖尿病(GDM)并发子痫前期(PE)孕妇76例(观察组)及妊娠期糖尿病(GDM)孕妇89例(对照组),应用彩色多普勒超声收集两组患者的胎儿脐动脉(UA)收缩末期最大血流速度和舒张末期最大血流速度比值(S/D值)、搏动指数(PI)、阻力指数(RI)等资料,并观察胎儿宫内发育情况及出生时新生儿情况(出生时体重,1分钟阿氏评分)。结果观察组的S/D值、PI、RI值均高于对照组(P<0.05),观察组1分钟阿氏评分较对照组低(P<0.05);两组胎儿宫内发育情况(包括双顶径、腹围、股骨径)及新生儿体重比较差异无统计学意义(P>0.05)。结论妊娠期糖尿病并发子痫前期对胎儿脐动脉血流及胎儿出生后1分钟阿氏评分具有一定的影响,因此应用彩色多普勒超声观察胎儿脐动脉血流情况,有助于判断妊娠期糖尿病孕妇是否并发子痫前期。

Objective To investigate the effect of gestational diabetes complicated with preeclampsia on fetal umbilical artery blood flow. Methods A total of 165 patients in our hospital were selected and divided into GDM ＋ PE group（ 76 patients,observation group） and GDM（ 89 patients,control group）. Two groups＇ peak systolic velocity / peak diastolic velocity（ S / D）,resistance indexes（ RI） and pulsatility indexes（ PI） of blood flow of umbilical artery by Color Doppler ultrasound were collected. The fetal development of the situation and newborns at birth（ birth weight,one minute Apgar score） was observed. Results PI,S / D and RI in observation group were higher than those in control group（ P0.05）.The one minute Apgar score in observation group was lower than that in control groups（ P0.05）. Intrauterine growth situation（ biparietal diameter,abdominal circumference,femur diameter） and neonatal were not statistically significant（ P0.05）. Conclusion It has effect of gestational diabetes complicated with preeclampsia on fetal umbilical artery blood flow and Apgar score. Color Doppler ultrasound is helpful to diagnose gestational diabetes complicated with preeclampsia.