系列检测法对提前预测妊娠期糖尿病巨大儿的临床价值

Serial sonographic measurements of fetal sizes in predicting macrosomia in gestational diabetes mellitus

目的利用系列超声检测法对晚孕期妊娠期糖尿病(GDM)胎儿腹围大小进行测量以提高巨大儿的检出率。方法选取2014年5月至2015年5月GDM胎儿2215例,将纳入标准的186例,根据出生时体重分成巨大儿组与非巨大儿组。分析GDM巨大儿组与同期GDM非巨大儿组的胎儿腹围大小及其增长速度。结果 GDM巨大儿组腹围其平均增长速度(9.4 mm/w)均高于同期GDM非巨大儿组(6.5 mm/w),差异有统计学意义(P<0.05)。且当GDM胎儿腹围值大于365 mm时,预测巨大儿的敏感度74.9%、特异性95.7%,具有较好的预测价值。结论利用系列超声检测法能够较为准确的预测GDM巨大儿的发生,并且如利用腹围预测巨大儿的最佳临界值为365 mm。

Objectives：This study aimed to determine whether antenatal serial sonographic measurements of fetal abdomen circumference in the Third trimester can predict macrosomia in women with gestational diabetes mellitus. Methods：785 GDM cases from May 2014 to May 2015 were divided into two groups,macrosomia group and Non-macrosomia group. Fetal sizes（BPD,HC,AC and FL）and the growth rate were compared between the two groups. Results：The average increment speeds of macrosomia group（9.4 mm/day）exceeded significantly those of Non-macrosomia group（9.4 mm/day）（P〈0.05）. The sensitivity and specificity of abdominal circumference which greater than 365 mm to detect macrosomia was 74.9% and 95.7%,respective. Conclusion：Third-trimester serial sonographic measurements of fetal soft-tissue may help to detect macrosomia in pregnancies complicated by pregestational diabetes.