妊娠期糖尿病与胎儿窘迫关系的探讨

The Relationship between Gestational Diabetes Mellitus and Fetal Distress

目的回顾性探究足月妊娠、自然临产的妊娠期糖尿病孕妇与胎儿窘迫的关系。方法方便选取该院从2015年1—12月收治的单胎足月妊娠、自然临产的患者200例作为研究对象,其中妊娠期糖尿病(GDM)组、血糖波动于理想范围100例;正常足月妊娠组100例,观察两组孕妇出现胎儿窘迫的差异性。结果妊娠期糖尿病(GDM)组患者的发生胎儿窘迫为10.0%,对照组的发生胎儿窘迫为3.0%,差异具有统计学意义(P<0.05)。结论自然临产、血糖控制理想的妊娠期糖尿病的孕妇仍比正常足月妊娠孕妇有更高的胎儿窘迫发生率。妊娠期糖尿病由于糖代谢异常,胎盘的绒毛数量增多、绒毛间隙相应缩小、潜在广泛微血管病变,使胎盘血管内皮细胞增厚及管腔变窄,可导致胎盘功能减退,胎盘血流灌注不足,最终出现胎儿缺氧。

Objective To retrospectively explore full-term pregnancy, spontaneous parturition of pregnant women with gestational diabetes and fetal distress relationship. Methods Convenient selection our hospital from January 2015 to December2015 singleton full-term pregnancy, natural labor 200 patients as the research object, including pregnancy gestational diabetes mellitus（GDM） group and blood glucose fluctuation in the ideal range of 100 cases; normal full-term pregnancy group（100 cases）, two groups of pregnant women to observe the difference of fetal distress. Results The incidence of fetal distress in patients with gestational diabetes mellitus（GDM） was 10.0%, the control group was 3.0%, the difference was statistically significant（P 〈0.05）. Conclusion Natural labor and blood glucose control ideal of gestational diabetes mellitus pregnant women still than normal term pregnant women have a higher incidence of fetal distress. Gestational diabetes mellitus due to abnormal glucose metabolism and placental villus number and intervillous space narrowing and potentially widespread microvascular disease, vascular endothelial cell in placenta thickening and luminal narrowing, and lead to the placental dysfunction, insufficient placental blood perfusion, culminating in fetal hypoxia.