妊娠合并糖尿病巨大儿的超声预测与分娩期处理

Ultrasound Prediction and Parturition Treatment of Macrosomia with Gestation Combined with Diabetes

目的分析超声预测在妊娠合并糖尿病孕妇巨大儿中的应用效果及其分娩期处理方法。方法选取2015年1月—2017年6月收治的100例妊娠合并糖尿病足月孕妇作为观察对象,所有孕妇行超声检查,观察胎儿的双顶径、腹围以及股骨长度,并以腹围超过35 cm作为判断标准对于巨大儿进行判断,同时将新生儿出生体重作为金标准判断超声预测的准确性。结果双顶径、腹围以及股骨长度与新生儿体重相关性为0.36、0.84、0.62,其中胎儿腹围与新生儿体重之间的相关性最高差异有统计学意义(P<0.05);超声检测巨大儿24例,而根据新生儿体重>4 kg判断巨大儿有28例,超声预测的准确率为85.7%。28例巨大儿中,24例剖宫产,1例引产失败、3例自然分娩。结论超声预测在妊娠合并糖尿病孕妇中具有较好的应用效果,能够通过胎儿腹围测量判断是否为巨大儿,能够为分娩方式的选择提供科学依据。

Objective To analyze the effect of ultrasound in the treatment of macrosomia in pregnant women with gestational diabetes and parturition treatment. Methods 100 cases of full-term pregnant women with pregnancy combined with diabetes from January 2015 to June 2017 were selected as research object, and all pregnant women were for ultrasound examination, and the biparietal diameter, abdominal circumference and femur length of fetuses were observed, and the giant babies were determined according to the standards that the circumference of abdomen was more than 35 cm, at the same time, the accuracy of ultrasound predication was determined according to the birth weight of newborns. Results The correlation between the two diameters, abdominal circumference and femoral length was 0.36, 0.84 and 0.62, with the highest correlation between fetal abdominal circumference and neonatal weight the difference was statistically significant（P〈0.05）. There were 24 cases of giant babies by the ultrasonography, but 28 cases by the weight of newborns〉4 kg, and accurate rate was 85.7%. Of the 28 cases, 24 were caesarean section,1 case was induced failure and 3 were natural delivery. Conclusion Ultrasonic prediction in gestational diabetes mellitus in pregnant women has a good application effect, which can determined whether the infant was giant baby or not according to the measurement of fetal abdominal circumference thus providing scientific basis for the delivery way.